Korean J Orthod.  2015 Jul;45(4):171-179. 10.4041/kjod.2015.45.4.171.

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

• Caprioglio A
• Cafagna A
• Fontana M
• Cozzani M

• KMID: 2400575
• DOI: http://doi.org/10.4041/kjod.2015.45.4.171

Abstract

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.

Keyword

Class II malocclusion; Molar distalization; Non-compliance; Intraoral distalizing devices; Skeletal anchorage

MeSH Terms

Bicuspid
Humans
Incisor
Male
Malocclusion
Molar*
Retrospective Studies
Statistics, Nonparametric

Figure

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  Figure 1 Pendulum appliance.

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  Figure 2 Distal screw appliance.

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  Figure 3 The measurements used in present study. A, Cephalometric measurements of skeletal tissues and soft tissues used in the study: 1, Upper lip to E-plane; 2, lower lip to E-plane; 3, SNA, Sella-Nasion-A-point; 4, SNB, Sella-Nasion-B-point; 5, ANB, A-point-Nasion-B-point; 6, PTV-A point; 7, PTV-B point; 8, SN-palatal plane angle; 9, SN-anatomic occlusal plane; 10, SN-mandibular plane angle; 11, lower anterior facial height (LAFH). B, Dental angular cephalometric measurements used in the study: 12, SN-maxillary incisor; 13, SN-maxillary first premolar; 14, SN-maxillary first molar; 15, SN-maxillary second molar. Dental linear cephalometric measurements: 16, PTV-maxillary incisor; 17, PTV-maxillary first premolar; 18, PTV-maxillary first molar; 19, PTV-maxillary second molar; 20, PP-maxillary incisor; 21, PP-maxillary first premolar; 22, PP-maxillary first molar; 23, PP-maxillary second molar; 24, overjet; 25, overbite. SN, Sella-nasion; A, A point; B, B point; PTV, pterygoid vertical; PP, palatal plane.

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  Figure 4 Graphic representation of maxillary superimposition for the pendulum group, showing dentoalveolar changes during the distalization phase (T1-T2).

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  Figure 5 Graphic representation of maxillary superimposition for distal screw group, showing dentoalveolar changes during the distalization phase (T1-T2).

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