Abstract
Class II malocclusions have traditionally been treated as nonextraction, extraction,
or orthognathic surgery depending on the severity of the dental and skeletal discrepancies.
To enhance function and improve esthetics with nonextraction treatment, functional
appliances, tooth-borne molar distalization, and Class II elastics have been used,
but they require patient cooperation and have drawbacks such as mesial movement of
the anchor teeth, molar extrusion, and flaring of the incisors. Recently, with the
application of temporary skeletal anchorage devices (TSADs) in patients with Class
II malocclusions, clinicians have been able to achieve total distalization of the
maxillary dentition without patient compliance and with less unwanted tooth movement.
Before a clinician uses a TSAD, they must consider where to place it and what type
to use for efficient, total arch distalization of the maxilla. TSADs such as miniscrews
and miniplates can be inserted on the buccal and palatal sides for total arch distalization.
When using them, the center of resistance of the entire maxillary dentition should
be determined to obtain en masse movement of the maxillary dentition by a statically
determinate force system. The treatment effects and the difference in biomechanics
between buccal miniscrews and modified C-palatal plates (MCPPs) for total arch distalization
of the maxilla are presented in this paper based on finite element and clinical studies.
Additionally, a strategy for efficient total arch distalization with MCPPs is discussed
along with considerations for the position of the second and third molars after total
arch distalization.
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References
- A comparison of two intraoral molar distalization appliances: distal jet versus pendulum.Am J Orthod Dentofacial Orthop. 2005; 128: 353-365
- Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty.Am J Orthod Dentofacial Orthop. 2009; 135 (698e1–10)
- Finite-element investigation of the center of resistance of the maxillary dentition.Korean J Orthod. 2009; 39: 83-94
- Treatment effects of microimplant-aided sliding mechanics on distal retraction of posterior teeth.Am J Orthod Dentofacial Orthop. 2011; 139: 470-481
- Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews.Angle Orthod. 2013; 83: 266-273
- Distal movement of maxillary molars using miniscrew anchorage in the buccal interradicular region.Angle Orthod. 2009; 79: 78-84
- Histologic evaluation of rootsurface healing after root contact or approximation during placement of mini-implants.Am J Orthod Dentofacial Orthop. 2011; 139: 752-760
- Effects of orthodontic force on root surface damage caused by contact with temporary anchorage devices and on the repair process.Korean J Orthod. 2019; 49: 106-115
- Root repair after contact with mini-implants: systematic review of the literature.Eur J Orthod. 2013; 35: 491-499
- Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment.Angle Orthod. 2020; 90: 362-368
- Distal movement of maxillary molars in nongrowing patients with the skeletal anchorage system.Am J Orthod Dentofacial Orthop. 2006; 129: 723-733
- Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents.Angle Orthod. 2015; 85: 657-664
- Full-step Class II Correction using a modified C-palatal plate for total arch distalization in an adolescent.J Clin Pediatr Dent. 2018; 42: 307-313
- A comparison of treatment effects of total arch distalization using modified C-palatal plate vs buccal miniscrews.Angle Orthod. 2018; 88: 45-51
- Treatment stability after total maxillary arch distalization with modified C-palatal plates in adults.Am J Orthod Dentofacial Orthop. 2019; 156: 832-839
- Comparison of tooth displacement between buccal mini-implants and palatal plate anchorage for molar distalization: a finite element study.Eur J Orthod. 2014; 36: 394-402
- Distalization pattern of whole maxillary dentition according to force application points.Korean J Orthod. 2015; 45: 20-28
- Application of palatal plate for nonextraction treatment in an adolescent boy with severe overjet.Am J Orthod Dentofacial Orthop. 2017; 152: 859-869
- Comparison of treatment effects between four premolar extraction and total archdistalization using the modified C-palatal plate.Korean J Orthod. 2018; 48: 224-235
- Displacement of mandibular dentition during total arch distalization according to locations and types of TSADs: 3D finite element analysis.Orthod Craniofac Res. 2019; 22: 46-52
- Distalization of molars with repelling magnets.J Clin Orthod. 1988; 22: 40-44
- Efficiency of a pendulum appliance for molar distalization related to second and third molar eruption stage.Am J Orthod Dentofacial Orthop. 2004; 125: 8-23
- Short-term cone-beam computed tomography evaluation of maxillary third molar changes after total arch distalization in adolescents.Am J Orthod Dentofacial Orthop. 2019; 155: 191-197
- Treatment effects of a modified palatal anchorage plate for distalization evaluated with cone-beam computed tomography.Am J Orthod Dentofacial Orthop. 2014; 146: 47-54
- Distal movement of the mandibular dentition with temporary skeletal anchorage devices to correct a Class III malocclusion.Am J Orthod Dentofacial Orthop. 2013; 144: 715-725
Article info
Publication history
Published online: July 01, 2020
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