Analysis of midpalatal miniscrew-assisted maxillary molar distalization patterns with simultaneous use of fixed appliances: A preliminary study / 대한치과교정학회지

Skeletal anchorage-assisted upper molar distalization has become one of the standard treatment modalities for the correction of Class II malocclusion. The purpose of this study was to analyze maxillary molar movement patterns according to appliance design, with the simultaneous use of buccal fixed orthodontic appliances. The authors devised two distinct types of midpalatal miniscrew-assisted maxillary molar distalizers, a lingual arch type and a pendulum type. Fourteen patients treated with one of the two types of distalizers were enrolled in the study, and the patterns of tooth movement associated with each type were compared. Pre- and post-treatment lateral cephalograms were analyzed. The lingual arch type was associated with relatively bodily upper molar distalization, while the pendulum type was associated with distal tipping with intrusion of the upper molar. Clinicians should be aware of the expected tooth movement associated with each appliance design. Further well designed studies with larger sample sizes are required.

A three-dimensional finite element analysis of molar distalization with a palatal plate, pendulum, and headgear according to molar eruption stage / 대한치과교정학회지

OBJECTIVE: This study aimed to (1) evaluate the effects of maxillary second and third molar eruption status on the distalization of first molars with a modified palatal anchorage plate (MPAP), and (2) compare the results to the outcomes of the use of a pendulum and that of a headgear using three-dimensional finite element analysis. METHODS: Three eruption stages were established: an erupting second molar at the cervical one-third of the first molar root (Stage 1), a fully erupted second molar (Stage 2), and an erupting third molar at the cervical one-third of the second molar root (Stage 3). Retraction forces were applied via three anchorage appliance models: an MPAP with bracket and archwire, a bone-anchored pendulum appliance, and cervical-pull headgear. RESULTS: An MPAP showed greater root movement of the first molar than crown movement, and this was more noticeable in Stages 2 and 3. With the other devices, the first molar showed distal tipping. Transversely, the first molar had mesial-out rotation with headgear and mesial-in rotation with the other devices. Vertically, the first molar was intruded with an MPAP, and extruded with the other appliances. CONCLUSIONS: The second molar eruption stage had an effect on molar distalization, but the third molar follicle had no effect. The application of an MPAP may be an effective treatment option for maxillary molar distalization.

Treatment effects of mandibular total arch distalization using a ramal plate / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. METHODS: Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, 23.9 ± 5.52 years) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001. RESULTS: The mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001). CONCLUSIONS: The mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.

Comparative evaluation of molar distalization therapy using pendulum and distal screw appliances / 대한치과교정학회지

OBJECTIVE: To compare dentoalveolar and skeletal changes produced by the pendulum appliance (PA) and the distal screw appliance (DS) in Class II patients. METHODS: Forty-three patients (19 men, 24 women) with Class II malocclusion were retrospectively selected for the study. Twenty-four patients (mean age, 12.2 +/- 1.5 years) were treated with the PA, and 19 patients (mean age, 11.3 +/- 1.9 years) were treated with the DS. The mean distalization time was 7 months for the PA group and 9 months for the DS group. Lateral cephalograms were obtained at T1, before treatment, and at T2, the end of distalization. A Mann-Whitney U test was used for statistical comparisons of the two groups between T1 and T2. RESULTS: PA and DS were equally effective in distalizing maxillary molars (4.7 mm and 4.2 mm, respectively) between T1 and T2; however, the maxillary first molars showed less distal tipping in the DS group than in the PA group (3.2degrees vs. 9.0degrees, respectively). Moreover, significant premolar anchorage loss (2.7 mm) and incisor proclination (5.0degrees) were noted in the PA group, whereas premolar distal movement (1.9 mm) and no significant changes at the incisor (0.1degrees) were observed in the DS group. No significant sagittal or vertical skeletal changes were detected between the two groups during the distalization phase. CONCLUSIONS: PA and DS seem to be equally effective in distalizing maxillary molars; however, greater distal molar tipping and premolar anchorage loss can be expected using PA.

Non-extraction treatment in Class III malocclusion by using improved superelastic NiTi wire / 대한치과교정학회지

Nonextraction camouflage treatment in mild Class III malocclusion is achieved by backward movement of the lower dentition and forward movement of the upper dentition. Many camouflage treatment modalities have been used for distal tipping and distal movement of mandibular posterior teeth. The amount of distal movement of mandibular dentition can be improved in cases of severe crowding, even without the patient's cooperation, by using miniscrews for anchorage. However, miniscrew insertion may be unsuccessful, and it may contact the adjacent root because of the distal movement of dentition. Distal tipping of mandibular dentition can be achieved using multiloop edgewise archwires and intermaxillary elastics. However, the complexity of this wire design causes discomfort to patients. Recently, a new treatment using improved superelastic NiTi wires (ISWs) and intermaxillary elastics has been introduced. ISWs can deliver orthodontic force more effectively, and their use with molar tip-back treatment has several advantages-this approach is effective, simple, and easy to use and reduces patient discomfort. The aim of this study was to report a case of camouflage treatment using ISW with tip-back and intermaxillary elastics for distal tipping of mandibular posterior dentition and to evaluate the effectiveness of this treatment in a clinical setting.

The frog appliance for upper molar distalization: a case report / 대한치과교정학회지

The purpose of this article was to evaluate the effects of a new upper molar distalization system, the Frog Appliance, on dentofacial structures in a Class II, division 1 patient. An 11-year-old girl was referred to our clinic for orthodontic treatment. She had a mild skeletal Class II malocclusion with Class II molar and canine relationship on both sides. The treatment plan included distalization of the upper first molars bilaterally followed by full fixed appliance therapy. For the upper molar distalization, a new system, the Frog Appliance, was constructed and applied. Lateral cephalometric radiographs were used to evaluate the treatment results. Distalization of the upper first molars was achieved in four months successfully, and Class I molar relationship was obtained. Total treatment time was 16 months. According to the results of the cephalometric evaluation, a nearly bodily distal molar movement with a slight anchorage loss was attained. In conclusion, the Frog Appliance was found to be a simple, effective, non-invasive, and compliance-free intraoral distalization appliance for achieving bilateral molar distalization.

Distal jet modification: an option in distalization / Modificación del distal jet: una opción en distalización

The objective of the present study was to describe how a distalizer can be made so that some failures existing in these devices can also be eliminated. Because such devices are easy to make and have a low cost, they are becoming a viable option for treating Class II malocclusions without extraction regardless of the patient’s co-operation.

El objetivo del presente estudio fue describir cómo un distalizador puede ser hecho de modo que algunos fracasos existentes en estos dispositivos también pueden ser eliminados. Debido a que estos dispositivos son fáciles de hacer y tienen un bajo costo, se están convirtiendo en una opción viable para el tratamiento de pacientes con maloclusiones clase II sin extracción independientemente de su cooperación.