Class II correction by maxillary en masse distalization using a completely customized lingual appliance and a novel mini-screw anchorage concept – preliminary results

Abstract

Background The aim of the study was to evaluate the efficacy of a novel en masse distalization method in the maxillary arch in combination with a completely customized lingual appliance (CCLA; WIN, DW Lingual Systems, Germany). Therefore, we tested the null-hypothesis of a significant deviation from an Angle-Class I canine relationship and a normal overjet defined by an individual target set-up after dentoalveolar compensation in Angle Class II subjects. Methods This retrospective study included 23 patients, (m/f 3/20, mean age 29.6 years (min/max, 13.6/50.9 years)), with inclusion criteria of an Angle Class II occlusion of more than half a cusp prior to en masse distalization and treatment completed consecutively with a CCLA in combination with a mini-screw (MS) anchorage for uni- or bilateral maxillary distalization (12 bilateral situations, totalling 35). Plaster casts taken prior to (T0) and following CCLA treatment (T3) were compared with the treatment plan / set-up (TxP, with a Class I canine relationship and a normal overjet as the treatment objective). MSs were placed following levelling and aligning (T1) and removed at the end of en masse distalization at T2. Statistical analysis was carried out using Schuirmann’s TOST [two one-sided tests] equivalence test, based on a one-sample t-test with α = 0.025 on each side (total α = 0.05). Results Ninety-seven percent of planned correction of the canine relationship was achieved (mean 3.6 of 3.7 mm) and also 97 % of the planned overjet correction (mean 3.1 of 3.2 mm), with a statistically significant equivalence (p < 0.0001) for canine relationship and overjet between the individual treatment plan (set-up) and the final outcome. Adverse effects were limited to the loss of n = 2 of 35 mini-screws. However, in each instance, the treatment was completed, as scheduled, without replacing them. Accordingly, the null-hypothesis was rejected. Conclusions The technique presented allows for a predictable correction of an Angle-Class II malocclusion via dentoalveolar compensation with maxillary en masse distalization.

Evaluating the Effects of Carriere Motion Appliance and Twin Block Appliances in Class II Correction—A Retrospective Study

“…These findings regarding the CMA are fairly similar to those reported in the literature [19,20,22,23,26]. In our study, the overjet correction attained using the CMA i exhibits a comparatively modest degree of adjustment relative to outcomes reported in other studies for alternative Class II corrective modalities, such as the Forsus [29] appliance and mini screws [13]. These latter approaches yield results that align more closely with the findings associated with the Twin Block appliance.…”

“…The correction of Class II malocclusion can also be achieved by upper molar distalization through various methods, including the Pendulum [11], Carriere Motion 3D™ appliance [12], and mini screws [13,14]. The Carriere Motion 3D™ appliance (CMA; Henry Schein Orthodontics, Carlsbad, CA, USA) was introduced in 2004.…”

Dentoalveolar and airway changes following en masse distal movement of the maxillary dentition with infrazygomatic crest anchorage: A prospective study

“…For maxillary en masse distal movement for dentoalveolar Class II correction, Beyling et al . [ 15 ] used a completely customized lingual appliance in combination with miniscrew anchorage and found that mean correction of the class II canine relationship of 0.43 mm per month from T1 to T2 was achieved with mini screw supported en masse distalization in an average of 10.5 ± 4.5 months (min. 5.2, max.…”

A Brief Review on Micro-Implants and Their Use in Orthodontics and Dentofacial Orthopaedics

“…The micro-implants as anchorage can be successfully used for the treatment of Class II malocclusions [59]. OMIs were included in a novel en masse distalization concept used for patients with canine sagittal distalizations of half of a cusp or more.…”

“…The objective of the study was to get a complete en-masse distalization of the whole upper arch in one step. By maxillary tooth movements and dentoalveolar compensations, the canine neutral relationship and the overjet correction were achieved [59].…”