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Objective: To evaluate and compare skeletal effects and the amount of molar distalization in maxilla using modified palatal anchorage plate (MPAP) vs headgear appliances in adolescent patients. Materials and Methods: Pre-and posttreatment lateral cephalograms of 45 Class II malocclusion patients were analyzed; 24 were treated with MPAP appliances (age, 12.4 years) and 21 with headgear (age, 12.1 years). Fixed orthodontic treatment started with the distalization process in both groups. Thirty-two variables were measured and compared between both groups using multivariate analysis of covariates. Results: There was no significant main effect of the appliance type on the treatment results (P 5 .063). Also, there was no significant main effect of the appliance type on both pre-and posttreatment comparisons (P 5 .0198 and .135, respectively). The MPAP and headgear groups showed significant distalization of maxillary first molars (3.06 6 0.54 mm and 1.8 6 0.58 mm, respectively; P , .001). Sagittal skeletal maxillomandibular differences were improved after treatment (P , .001), with no significant differences between the two groups. No significant difference in treatment duration was found between the groups. Conclusions: The MPAP showed a significant skeletal effect on the maxilla. Both MPAP and headgear resulted in distalization of maxillary first molars. Therefore, it is recommended that clinicians consider the application of MPAP, especially in noncompliant Class II patients. (Angle Orthod. 2015;85:657-664.)

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