scholarly journals Efficiency of the skeletonized Pendulum K appliance for non-compliance maxillary molar distalization

2021 ◽  
Author(s):  
Gero Stefan Michael Kinzinger ◽  
Jan Hourfar ◽  
Jörg Alexander Lisson
Keyword(s):  
Side Effects ◽  
Lower Percentage ◽  
Molar Distalization ◽  
Maxillary Molars ◽  
Maxillary Molar ◽  
Force Moment ◽  
Maxillary Premolars ◽  
Anchorage Loss ◽  
Upper Molar

Abstract Purpose Conventional anchorage with exclusively intraorally anchored appliances for non-compliance molar distalization combines a palatal acrylic button with periodontal anchorage. This type of anchorage is critically discussed because of the temporary hygienic impairment of the palate and the uncertain anchoring quality of the button. A purely dentally/periodontally anchored Pendulum K appliance was developed, which is exclusively anchored via four occlusal rests. The aims of this pilot study were to examine the suitability of the skeletonized Pendulum K for distalization of maxillary molars, and to investigate the quality of this alternative anchoring modality. Patients and methods In all, 10 patients received skeletonized Pendulum K appliances attached to all maxillary premolars for bilateral molar distalization. Supporting anchorage through an acrylic button adjacent to the anterior palate was not used. The pendulum springs were initially activated on both sides with a distalization force of 220 cN each and provided with uprighting and toe-in bends. The specific force/moment system was regularly reactivated intraorally by adjustment of the distal screw. Results The study demonstrates the suitability of the skeletonized Pendulum K appliance for the distalization of maxillary molars (3.28 ± 0.73 mm). Side effects on the molars were slight distal tipping (3.50 ± 2.51°/PP, 3.00 ± 1.41°/SN) and mesial inward rotation (average 2.75 ± 7.50° and 4.50 ± 12.77°). Significant anchorage loss occurred in the form of mesialization of the incisors by 1.40 ± 0.82 mm and of the first premolars by 2.28 ± 0.85 mm. Conclusion The skeletonized Pendulum K appliance allows compliance-free upper molar distalization. Exclusively dental/periodontal anchorage resulted in a lower percentage of molar distalization compared to a conventional anchoring preparation of the Pendulum K with a palatal acrylic button. Anchorage loss had a comparatively stronger effect on the anchoring premolars but less on the incisors. Typical side effects on the molars such as distal tipping and mesial inward rotation were remarkably low.

scholarly journals Evaluation of the effects of the hybrid Pendulum in comparison with the conventional Pendulum appliance

2019 ◽  
Vol 90 (2) ◽  
pp. 194-201
Author(s):  
Erdal Bozkaya ◽  
Tuba Tortop ◽  
Sema Yüksel ◽  
Emine Kaygısız
Keyword(s):  
Wilcoxon Test ◽  
Treatment Results ◽  
Molar Distalization ◽  
Angle Class Ii ◽  
Maxillary Molars ◽  
Lateral Cephalograms ◽  
Maxillary Molar ◽  
Pendulum Appliance ◽  
The Mean ◽  
Anchorage Loss

ABSTRACT Objective: To evaluate the anchorage control and distalization of maxillary molars with the hybrid Pendulum appliance and to compare the results with a conventional Pendulum appliance. Materials and Methods: This study was carried out on the pre-(T0) and post-(T1) treatment lateral cephalograms and dental casts of 43 patients with Angle Class II molar relationships who were treated with conventional or hybrid Pendulum appliances. The hybrid Pendulum (HP) group consisted of 22 patients (14 females; eight males; mean age 14.3 ± 2.43 years) and treatment results were compared with a conventional Pendulum appliance (CP) group, which consisted of 21 patients (15 females; six males; mean age 14.6 ± 3.39 years). Intragroup comparisons were made with Wilcoxon test and intergroup comparisons were made with Mann-Whitney U-test (P < .05). Results: The mean distalization duration was 0.70 ± 0.25 years in the HP group and 0.83 ± 0.4 years in the CP group. Maxillary first molars showed significant distal movement and tipping of 4.25 mm and 9.09° in the HP group, and 3.21 mm and 9.86° in the CP group. Loss of anchorage at the first premolars was significantly smaller in the HP appliance group compared to CP group. The second premolars distalized spontaneously in the HP group while they mesialized significantly in the CP group. Proclination and protrusion of maxillary incisors were greater with the CP appliance compared to the HP appliance. Conclusions: Maxillary molar distalization was achieved with both appliances. Mesialization of the anchorage unit was controlled successfully with the hybrid Pendulum; however, the conventional Pendulum appliance caused anchorage loss.

scholarly journals Intraoral Maxillary Molar Distalization

2006 ◽  
Vol 76 (6) ◽  
pp. 923-929 ◽  
Author(s):  
Ingela Karlsson ◽  
Lars Bondemark
Keyword(s):  
Sample Size ◽  
Orthodontic Treatment ◽  
Treatment Time ◽  
Sample Size Calculation ◽  
Movement Rate ◽  
Molar Distalization ◽  
Maxillary Molars ◽  
Maxillary Molar ◽  
The Mean ◽  
Anchorage Loss

Abstract Objective: To evaluate the maxillary molar distalization and anchorage loss in two groups, one before (MD 1 group) and one after (MD 2 group) eruption of second maxillary molars. Materials and Methods: After a sample size calculation, 20 patients were recruited for each group from patients who fulfilled the following criteria: no orthodontic treatment before distal molar movement, Class II molar relationship defined by at least end-to-end molar relationship, space deficiency in the maxilla, and use of an intra-arch NiTi coil appliance with a Nance appliance to provide anchorage. Patients in the MD 1 group were without any erupted second molars during the distalization period, whereas in the MD 2 group both the first and second molars were in occlusion at start of treatment. The main outcome measures to be assessed were: treatment time, ie, time in months to achieve a normal molar relation, distal movement of maxillary first molars, and anterior movement of maxillary incisors (anchorage loss). The mean age in the MD 1 group was 11.4 years; in the MD 2 group, 14.6 years. Results: The amount of distal movement of the first molars was significantly greater (P < .01) and the anchorage loss was significantly lower (P < .01) in the group with no second molars erupted. The molar distalization time was also significantly shorter (P < .001) in this group, and thus the movement rate was two times higher. Conclusions: It is more effective to distalize the first maxillary molars before the second molars have erupted.

scholarly journals Dentoskeletal Class II Malocclusion: Maxillary Molar Distalization with No-Compliance Fixed Orthodontic Equipment

2020 ◽  
Vol 8 (1) ◽  
pp. 26
Author(s):  
Vincenzo Quinzi ◽  
Enrico Marchetti ◽  
Luigi Guerriero ◽  
Floriana Bosco ◽  
Giuseppe Marzo ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Final Analysis ◽  
Class Ii ◽  
Dental Arch ◽  
Class Ii Malocclusion ◽  
Exclusion Criteria ◽  
Molar Distalization ◽  
Maxillary Molars ◽  
Maxillary Molar ◽  
Orthodontic Devices

Dentoskeletal class II malocclusion due to a protruded upper dental arch is a major reason for an orthodontic treatment. In these cases, the correction of class II can be hindered by molar distalization, obtained with ‘no-compliance therapy’ that involves the use of appliances which minimize the need for such co-operation and attempt to maximize the predictability of results. The aim of this review was to outline the effectiveness of no-compliance fixed orthodontic devices in the molar distalization. After selection according to the inclusion/exclusion criteria, 16 articles from 2000 to 2019 were qualified for the final analysis. The literature shows various no-compliance fixed devices whose effect is to distalize the maxillary molars. The present revision allows to conclude that there is a need to increase the number of studies, especially with regard to the most recently introduced devices in the literature. The analysed studies allow to hypothesize that these appliances act with a minimal variability of molar distalization and disto-inclination among them, although different effects among the appliances can be observed as regards to the anchorage.

scholarly journals Effects of Variable Composite Attachment Shapes in Controlling Upper Molar Distalization with Aligners: A Nonlinear Finite Element Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Cengiz Ayidağa ◽  
Beste Kamiloğlu
Keyword(s):  
Finite Element ◽  
Stress Distribution ◽  
Periodontal Ligament ◽  
Alveolar Bone ◽  
Molar Distalization ◽  
The Third ◽  
Maxillary Molar ◽  
Von Mises ◽  
Displacement Patterns ◽  
Upper Molar

The objective of the present study is to describe the stress and displacement patterns created by clear aligners and composite attachments bonded with the acid-etch technique on the labial surface of the maxillary first upper molar during its distalization. Maxillary molar distalization is a clinical orthodontics procedure used to move the first maxillary molar distally. The procedure is useful in patients with some Class II malocclusion allowing the first molar to move into a Class I relationship and the correction of associated malocclusion features. Three finite element models were designed to simulate the alveolar bone, molar tooth, periodontal ligament, aligner, and composite attachments. The first model had no composite attachment, the second model had a vertical rectangular attachment, and the third model had a newly designed attachment. A loading method was developed that mimicked the aligner’s molar distal movement. PDL was set as a viscoelastic material with a nonlinear mechanical response. von Mises and maximum principal stresses and tooth displacement patterns were analyzed using dedicated software. All the configurations showed some form of clockwise rotation in addition to the distal movement. The crown portion of the tooth showed maximum displacement in all three models; however, in the absence of attachment, the root apex moved in the opposite direction which was compatible with uncontrolled tipping movement. Simulations with attachments exhibited the best performance regarding the movement patterns. The third group, with the newly designed attachment, exhibited the best performance concerning stress distribution (principal stress and von Mises stresses) and higher stresses in the periodontal ligament and tooth. Incorporating a vertical rectangular attachment in a clear aligner resulted in the reduction of mesiodistal tipping tendency during molar distalization. The third model was the most efficient considering both displacement pattern and stress distribution. The level of stress generated by the third model needs to be further investigated in future studies.

UTILIZAÇÃO DO MINI-IMPLANTE COMO ANCORAGEM PARA DISTALIZAÇÃO DE MOLAR SUPERIOR

2017 ◽  
Author(s):  
Thereza Christina Lopes Coutinho
Keyword(s):  
Treatment Time ◽  
Skeletal Anchorage ◽  
Orthodontic Anchorage ◽  
Molar Distalization ◽  
Mini Implants ◽  
Maxillary Molars ◽  
Maxillary Molar ◽  
Orthodontic Anchorage Procedures ◽  
Reaction Unit ◽  
Intraoral Devices

RESUMOO uso dos mini-implantes como recurso de ancoragem para distalização de molar superior tem a finalidade de evitar a movimentação indesejável da unidade de reação, proporcionando uma série de vantagens quando comparados à aparelhos extrabucais ou intrabucais, aparelhos estes, que necessitam da colaboração dos pacientes e tem um comprometimento estético. Por isso, os mini-implantes têm sido cada vez mais associados aos diversos sistemas distalizadores, buscando uma ancoragem absoluta, facilitando e aprimorando os procedimentos de ancoragem ortodôntica, reduzindo o tempo e dando uma maior previsibilidade ao resultado do tratamento. A distalização dos molares superiores tem se mostrado uma excelente técnica para correção de classe II e III de Angle. O objetivo deste trabalho é realizar uma revisão de literatura, avaliando os métodos utilizados para se obter uma eficiente distalização de molar ancorados por mini-implantes.Palavras – chave: Ancoragem esquelética – Mini-implantes – Microparafuso ortodôntico ABSTRACT            The use of miniscrews anchorage for distalization of maxillary molars is intended to prevent unwanted movement of the reaction unit, providing a series of advantages when compared to the extraoral or intraoral devices, appliances those which require the patients’ collaboration and have aesthetical problems. So the miniscrews have been increasingly associated with various distalization systems, seeking an absolute anchorage, facilitating and improving the orthodontic anchorage procedures, reducing treatment time and providing greater predictability to the treatment outcome. The maxillary molar distalization has proven to be an excellent technique for correction of class II and III malocclusions. The aim of this study is to review the literature, assessing the methods used to obtain an effective molar distalization anchored by miniscrews.Keywords: Skeletal anchorage – Mini-implants – Orthodontic miniscrews

scholarly journals Upper Second Molar Distalization with Clear Aligners: A Finite Element Study

2020 ◽  
Vol 10 (21) ◽  
pp. 7739
Author(s):  
Gabriele Rossini ◽  
Matteo Schiaffino ◽  
Simone Parrini ◽  
Ambra Sedran ◽  
Andrea Deregibus ◽  
...  
Keyword(s):  
Finite Element ◽  
Periodontal Ligament ◽  
Element Analysis ◽  
Molar Distalization ◽  
Force System ◽  
Second Molar ◽  
Maxillary Molar ◽  
Clinical Environments ◽  
Upper Molar ◽  
Element Study

Among orthodontists and scientists, in the last years, upper molar distalization has been a debated topic in the orthodontic aligner field. However, despite that few clinical studies have been published, no insights on aligners’ biomechanics regarding this movement are available. The aim of this study was to assess, through finite element analysis, the force system resulting in the upper arch during second maxillary molar distalization with clear aligners and variable attachments settings. The average tooth distalization was found to be 0.029, with buccal flaring of the upper incisors in all attachment configurations. The mesial deformation of the aligner was registered to be 0.2 mm on average. Different pressure areas on the interface between aligners and upper molars were registered, with the mesial attachment surface to be directly involved when present. Periodontal ligament pressure was reported to range between 67 g/cm2 and 132 g/cm2. Configurations with rectangular attachments from second molar-to-canine and from first molar-to-canine present, in an in silico environment, almost equal efficiency in distalizing the upper second molar. However, attachments from the second molar to the canine are suggested to be adopted in clinical environments due to greater feasibility in everyday practice.

scholarly journals Comparative Distalization Effects Of Conventional Pendulum Appliance And Bone Anchored Pendulum Appliance

2018 ◽  
Vol 08 (01) ◽  
pp. 03-010
Author(s):  
Crystal Runa Soans ◽  
Ashutosh Shetty ◽  
Murali P.S ◽  
Azhar Mohammed ◽  
U.S Krishna Nayak ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Orthodontic Anchorage ◽  
Molar Distalization ◽  
Maxillary Molars ◽  
Lateral Cephalograms ◽  
Treatment Stage ◽  
Pendulum Appliance ◽  
Pre Treatment ◽  
Anchorage Loss ◽  
Dental Cast

Abstract Introduction: The introduction of intraosseous screws as temporary orthodontic anchorage devices has proved successful in achieving sufficient molar distalization without major anchorage loss in Class II malocclusions. Bone-anchored pendulum appliance is used to obtain an effective and compliance-free molar distalization without anchorage loss. Aims And Objectives: This prospective study was designed to evaluate and compare the skeletal and dentoalveolar effects produced by 2 types of pendulum appliance with different anchorage modalities - the Bone anchored pendulum appliance (BAPA) and Conventional pendulum appliance (CPA) in subjects with Angle's ClassII malocclusion. Materials and Methods: BAPA group consisted of 5 patients with mean age, 16.4±1.5 years. The CPA group consisted of 5 patients with mean age, 16.6±1.1 years. Lateral cephalograms & dental casts were obtained at pre-treatment stage & after achieving Class I molar relation. Dentoalveolar, skeletal, soft tissue measurements and dental cast measurement were recorded & compared between the groups. Results and Conclusions: Successful distalization was achieved in both groups in a mean period of 6.2 months for BAPA and 5.2 months for CPA. It was concluded that, both theBAPA and CPA were effective for the distalization of maxillary molars. Though the distal molar movements obtained were similar between the BAPA and the CPA groups, anchorage loss was observed with the CPA in the form of premolar mesialization & incisor proclination, whereas absence of anchorage loss, significant spontaneous distal premolar movement, and distal incisor movement was observed with the BAPA, making it a viable choice compared to the CPA.

scholarly journals Comparison of Maxillary Molar Distalization with an Implant-Supported Distal Jet and a Traditional Tooth-Supported Distal Jet Appliance

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mauro Cozzani ◽  
Marco Pasini ◽  
Francesco Zallio ◽  
Robert Ritucci ◽  
Sabrina Mutinelli ◽  
...  
Keyword(s):  
Treatment Time ◽  
Molar Distalization ◽  
Skeletal Changes ◽  
Wilcoxon Rank Sum Test ◽  
Lateral Cephalograms ◽  
Maxillary Molar ◽  
The Mean ◽  
Anchorage Loss ◽  
Distal Jet ◽  
Values Distribution

Aim. To investigate and compare the efficiency of two appliances for molar distalization: the bone-anchored distal screw (DS) and the traditional tooth-supported distal jet (DJ) for molar distalization and anchorage loss.Methods.Tests (18 subjects) were treated with a DS and controls (18 subjects) were treated with a DJ. Lateral cephalograms were obtained before and at the end of molar distalization and were analysed. Shapiro Wilk test, unpairedt-test, and Wilcoxon rank-sum test were applied according to values distribution. Theαlevel was fixed at 0.05.Results. Maxillary first molars were successfully distalized into a Class I relationship in all patients. The mean molar distalization and treatment time were similar in both groups. The DS group exhibited a spontaneous distalization (2.1±0.9 mm) of the first premolar with control of anchorage loss, distal tipping, extrusion, and skeletal changes.Conclusions. The DS is an adequate compliance-free distalizing appliance that can be used safely for the correction of Class II malocclusions. In comparison to the traditional DJ, the DS enables not only a good rate of molar distalization, but also a spontaneous distalization of the first premolars.

scholarly journals Distal Movement of Maxillary Molars Using a Lever-arm and Mini-implant System

2008 ◽  
Vol 78 (1) ◽  
pp. 167-175 ◽  
Author(s):  
Seung-Min Lim ◽  
Ryoon-Ki Hong
Keyword(s):  
Side Effects ◽  
Three Dimensional ◽  
Dimensional Control ◽  
Lever Arm ◽  
Mini Implants ◽  
Temporary Anchorage Devices ◽  
Maxillary Molars ◽  
Implant System ◽  
Anchorage Loss ◽  
Posterior Area

Abstract Recently, many studies have been reported on distal molar movement using temporary anchorage devices. However, the side effects of distal movement, such as distal tipping, rotation, or extrusion, are still unsolved. This article describes the use of the lever-arm and mini-implant system for controlled distal movement of maxillary molars and two clinical cases in which patients were treated with this system. Mini implants are needed to control the point of force application in the posterior area with no anchorage loss. When the length of the lever arm and the position of the mini implant are adjusted, the desired line of action of the distal force is determined with respect to the center of resistance of maxillary molars. The lever-arm and mini-implant system is useful not only for absolute anchorage, but also for three-dimensional control during distal movement of the upper molars.

scholarly journals Effect of second molar eruption on efficiency of maxillary first molar distalization using Carriere distalizer appliance

2021 ◽  
Vol 26 (4) ◽  
Author(s):  
Ahmed Shawky HASHEM
Keyword(s):  
Class Ii ◽  
Molar Distalization ◽  
Mandibular Incisor ◽  
Second Molar ◽  
Skeletal Changes ◽  
Computed Tomography Images ◽  
Before And After ◽  
Maxillary Molar ◽  
Treatment Onset ◽  
Anchorage Loss

ABSTRACT Introduction: Maxillary molar distalization is a common approach for correcting dental Class II malocclusions. Objective: This study aimed at comparing the outcomes of maxillary first molar distalization using the Carriere appliance before and after second molar eruption. Methods: Two groups of patients with dental Class II malocclusions were treated with Carriere distalizer appliance with heavy rectangular mandibular wire and lingual arch for anchorage. Patients of the first group presented unerupted maxillary second molars during the distalization period. In the second group, maxillary second molars were in occlusion on treatment onset. Cone beam computed tomography images were taken at the beginning of treatment and after finishing molar distalization, to compare both groups regarding first molar distalization, intrusion, mesiodistal tipping, buccolingual torquing and rotation, anchorage loss and skeletal changes. Also, the treatment durations were compared. Results: The mean first molar distalization period in the first group (19.2 ± 1.6 weeks) was significantly smaller than the second group (23.3 ± 2.3 weeks). The amount of maxillary first molar distalization was significantly greater, while the amount of rotation was significantly smaller in the first group. No statistically significant differences in the amounts of maxillary first molar intrusion, mesiodistal tipping and buccolingual torquing between both groups was found. Mandibular incisor labiolingual torquing and mandibular first molar mesialization and mesiodistal tipping were significantly greater in the second group. Conclusions: Maxillary first molar distalization before maxillary second molar eruption is more efficient, with less anchorage loss than after second molar eruption.

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