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

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.

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

The Angle Orthodontist ◽

10.2319/051719-340.1 ◽

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.

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

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie ◽

10.1007/s00056-021-00280-8 ◽

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.

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

International Journal of Science Dentistry ◽

10.22409/ijosd.v2i46.345 ◽

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

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Intraoral Maxillary Molar Distalization

The Angle Orthodontist ◽

10.2319/110805-390 ◽

2006 ◽

Vol 76 (6) ◽

pp. 923-929 ◽

Cited By ~ 31

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.

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

International Journal of Dentistry ◽

10.1155/2014/937059 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 12

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.

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Soft Tissue Profile after Distal Molar Movement with a Pendulum K-Loop Appliance Versus Cervical Headgear

The Angle Orthodontist ◽

10.2319/011107-10.1 ◽

2008 ◽

Vol 78 (2) ◽

pp. 317-323 ◽

Cited By ~ 6

Author(s):

Omur Polat-Ozsoy ◽

Aylin Gokcelik ◽

Ahu Güngör-Acar ◽

Beyza Hancioglu Kircelli

Keyword(s):

Soft Tissue ◽

Loop Group ◽

T Test ◽

Upper Lip ◽

Skeletal Class ◽

Soft Tissue Profile ◽

Lateral Cephalograms ◽

Significant Difference ◽

Treatment Changes ◽

Pendulum Appliance

Abstract Objective: To evaluate the soft tissue changes associated with the pendulum appliance that was supported with a K-loop buccally and to compare these treatment changes with a cervical headgear group. Materials and Methods: The records of 30 patients having skeletal Class I, dental Class II malocclusions were divided to two groups. Group 1 consisted of 7 girls, 8 boys (mean age, 15.0 ± 3.4 years), and Group 2 consisted of 10 girls, 5 boys (mean age 14.2 ± 2.9 years). The first group was treated with a pendulum appliance that was supported with a K-loop buccally, and the second group was treated with cervical headgear. Lateral cephalograms were taken at the beginning of treatment and at the end of distal molar movement. Treatment changes within the groups were analyzed using the paired t-test, and between group changes were analyzed with the independent t-test. Results: The results showed that the pendulum/K-loop appliance had no significant effect on skeletal and dental variables and soft tissue A point, upper lip thickness, and sagittal upper lip position relative to the E plane. A significant difference for the change in Vp-Ls distance was found in patients in the pendulum/K-loop group (P < .05). Patients in the cervical headgear group showed significant retrusion in skeletal, dental, and soft tissue measurements (P < .05). Conclusions: The pendulum/K-loop appliance produces distal molar movement without causing any significant changes in the sagittal or vertical positions of either the jaw or the soft tissue profile.

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Maxillary premolars extraction or molar distalization with or without TADs: cephalometric evaluation of soft tissue changes in Class II treatment

South European Journal of Orthodontics and Dentofacial Research ◽

10.5937/sejodr7-23776 ◽

2020 ◽

Vol 7 (1) ◽

pp. 4-11

Author(s):

Lorenz Moser ◽

Enrica Di Lorenzo ◽

Marco Serafin ◽

Giuliano Maino ◽

Ute Schneider-Moser ◽

...

Keyword(s):

Soft Tissue ◽

Class Ii ◽

Growth Spurt ◽

Class Ii Malocclusion ◽

Premolar Extraction ◽

Class Ii Treatment ◽

Lateral Cephalograms ◽

Tissue Changes ◽

Pendulum Appliance ◽

Soft Tissue Changes

Introduction: Problem solving in Class II malocclusion treatment performed with premolars extractions or distalizing techniques in relation to the profile modification. Aim: To cephalometrically compare soft tissue changes produced either by maxillary premolar extraction, tooth-borne Pendulum appliance or bone-borne MGBM appliance. Materials and Methods: Both pre- (T1) and post-treatment (T2) lateral cephalograms of 89 skeletal Class II patients (36 M, 53 F), treated during pubertal growth spurt, were retrospectively selected. Three groups were formed based on the therapy performed: 30 patients had been treated with maxillary first premolars extraction (U4), 31 patients with a conventional tooth-borne distalizing with Pendulum appliance (PA), and 28 patients with a skeletally anchored distalizing appliance (MGBM). Soft tissue was analyzed comparing upper (UL) and lower (LL) lip’s points with regard to True Vertical Line (TVL) and Esthetic plane (E-plane). Skeletal and dental values have been recorded in order to cephalometrically compare ΔT2-T1 changes among groups and to correlate dental and skeletal changes to profile modifications. One-way ANOVA was employed to compare groups at T1. Paired sample t-tests were employed to assess significant intra- and intergroup differences between T2 and T1. Significance level was set at 0.05 Results: UL and LL showed a slight but not significant retrusion relative to TVL in all three groups. UL and LL distances to E-plane were not statistically significant among U4, PA, and MGBM groups. Independently of the treatment, UL was tangent to TVL in all groups. No statistically significant differences have been shown in skeletal records. Significant differences were recorded in Overjet among U4 than PA and MGBM groups. Conclusions: Class II malocclusion treatment with maxillary first premolar extraction, conventional or skeletal distalization did not significantly affect the profile producing similar changes in the soft tissue.

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Comparison of the Pendulum appliance and the Jones Jig: A prospective comparative study

European Journal of Dentistry ◽

10.4103/ejd.ejd_295_16 ◽

2017 ◽

Vol 11 (03) ◽

pp. 323-329 ◽

Cited By ~ 3

Author(s):

Sushruth Shetty ◽

Rajkumar Maurya ◽

H. V. Pruthvi Raj ◽

Anand Patil

Keyword(s):

Class Ii ◽

Class Ii Malocclusion ◽

Test Results ◽

Molar Distalization ◽

Facial Height ◽

Lateral Cephalograms ◽

Prospective Comparative Study ◽

Treatment Changes ◽

Pendulum Appliance ◽

Paired T Test

ABSTRACT Objective: To compare two molar distalization devices, the Pendulum appliance (PA) and the Jones Jig (JJ) in dental Class II patients. Materials and Methods: Pretreatment and postdistalization lateral cephalograms and study models of 20 subjects (6 males, 14 females) Class II malocclusion subjects were examined. PA and JJ group both consisted of 10 patients each with a mean pretreatment age of 12 years 1 month for females and 12 years 5 months for males. The PA and the JJ appliance were activated once in a month until Class II molar relationship was corrected to a super Class I molar relationship in both groups. Initial and final measurements and treatment changes were compared by means of Paired t-test. Results: Maxillary first molar distalized an average of 3.85 mm in the PA and 2.75 mm in the JJ between T1 and T2; rate of molar distalization was 1.59 mm/month for PA, and the JJ appliance averaged 0.88 mm/month, distal molar tipping was greater in PA (6.2°) than in the JJ (3.9°). Average mesial movement of the premolars was 2.2 mm with PA and JJ both. JJ showed a greater rotation of first molars after distalization as compared to PA. The increase in vertical facial height was also greater for JJ as compared to PA. Conclusions: Both the appliances were effective in molar distalization with PA requiring less distalization time (16 days less than JJ). Some adverse effects were noted with both which one should strive to control.

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What is the best soft-tissue reference plane to quantify lip change in bimaxillary protrusion cases? A retrospective cohort study

APOS Trends in Orthodontics ◽

10.25259/apos_136_2020 ◽

2020 ◽

Vol 10 ◽

pp. 178-184

Author(s):

Mustafa Nasar ◽

Donald J. Ferguson ◽

Johnny Joung-Lin Liaw ◽

Laith Makki ◽

Nikhilesh R. Vaid

Keyword(s):

Soft Tissue ◽

Post Treatment ◽

Reference Plane ◽

Treatment Change ◽

Lower Lip ◽

Soft Tissue Profile ◽

Lateral Cephalograms ◽

Significant Difference ◽

Pre Treatment ◽

Bimaxillary Protrusion

Objectives: The objective of the study was to evaluate the validity of five soft-tissue profile planes to actual horizontal lower lip changes following treatment of severe bimaxillary protrusion patients with vertical maxillary excess using extra-alveolar miniscrews. The null hypothesis was no differences in the incremental changes of horizontal lower lip changes from pre-treatment to post-treatment of the five methods compared to actual changes. Materials and Methods: Seventy adults were treated orthodontically with extractions for bimaxillary protrusion and “gummy” smile using extra-alveolar miniscrews. Lower lip horizontal position was assessed with pre- and post-treatment lateral cephalograms and five commonly used soft-tissue reference lines were used to measure horizontal lower lip treatment change. Results: Compared to actual therapeutic lower lip horizontal retraction (4.38 mm), soft-tissue references Ricketts’ E-line (3.89 mm) and Steiner’s S-line (3.88 mm) demonstrated no statistical difference (P > 0.05) from actual change. The five profile plane measures showed moderately high to high intercorrelations among themselves, but none of them were related to the actual amount of anteroposterior lip change that occurred. None of the five soft-tissue measurements showed a statistically significant difference (P > 0.05) between subgroups with least and greatest lower lip retraction. Conclusion: Under conditions of maximum lower lip retraction, Rickett’s E-line and Steiner’s S-line were fair measures of horizontal lower lip change. Although actual lower lip change and soft-tissue reference plane changes were correlated poorly, intercorrelations among the five soft-tissue references planes were moderately high. None of the five soft-tissue measurements was able to discriminate (P > 0.05) between treatments with least and greatest lower lip retraction. It may be concluded that Rickett’s E-line and Steiner’s S-line soft-tissue profile references are valid when there is considerable therapeutic retraction (4+ mm) of the lower lip.

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Comparison of two implant-supported molar distalization systems

The Angle Orthodontist ◽

10.2319/080512-630.1 ◽

2012 ◽

Vol 83 (3) ◽

pp. 460-467 ◽

Cited By ~ 31

Author(s):

Cagla Sar ◽

Burcak Kaya ◽

Omur Ozsoy ◽

Ayca Arman Özcirpici

Keyword(s):

Statistical Evaluation ◽

T Test ◽

Class Ii Malocclusion ◽

Posterior Teeth ◽

Angle Class Ii ◽

Maxillary Molars ◽

Lateral Cephalograms ◽

Pendulum Appliance ◽

Miniscrew Implant ◽

Maxilla And Mandible

ABSTRACT Objective: To examine skeletal, dental, and soft tissue effects of the Miniscrew Implant Supported Distalization System (MISDS) and the Bone-Anchored Pendulum Appliance (BAPA). Materials and Methods: Among 28 patients displaying Angle Class II malocclusion, 14 patients with a mean age of 14.8 ± 3.6 years treated with MISDS were included in the first group, and 14 patients with a mean age of 14.5 ± 1.5 years treated with BAPA were included in the second group. The pretreatment and posttreatment lateral cephalograms were analyzed. Statistical evaluation was carried out using the paired Shapiro-Wilk test, the paired-sample t-test, and the unpaired t-test. Results: Upper posterior teeth were distalized successfully in both groups. Nearly bodily distalization was seen in the MISDS group, whereas significant distal tipping of the upper first molars was observed in the BAPA group (P < .001). There were no statistically significant changes in the sagittal position of the maxilla and mandible and in the position of the upper incisors as a result of treatment in either group. Conclusions: Both methods provided absolute anchorage for distalization of posterior teeth; however, almost translatory distal movement was encountered in the MISDS group, and substantial distal tipping of the maxillary molars accompanied distalization in the BAPA group.

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