Intraoral distalizer effects with conventional and skeletal anchorage: A meta-analysis

Comparison between direct vs indirect anchorage in two miniscrew-supported distalizing devices

“…As stated by Grec et al, 10 only direct skeletal anchorage can provide absolute anchorage, and spontaneous distal premolar movement could also be observed. Accordingly, our study showed that premolars were distally pulled by the transseptal fibers during distalization of the first molar (22.2 mm; 95% CI 5 22.9, 21.6).…”

“…However, the main difference between MGBM and DS was represented by the premolar movement (Figures 4 and 5). MGBM, using an indirect skeletal anchorage, 10 could not provide absolute anchorage because of the low rigidity of the metallic ligatures, so that the premolar showed a small mesial movement of 1.4 mm (95% CI 5 0.7, 2.1) and the incisors showed a slight proclination of 1.6u (95% CI 5 0.3, 3.2) after the distalization phase. Moreover, Liou et al 22 reported that the absence of osseointegration and the bone elasticity could lead to a certain mobility of the miniscrews, which, while not necessarily compromising the final outcome, 23 could result in anchorage loss regardless of whether the screws are indirectly connected to the anchorage unit.…”

“…On the contrary, buccal interradicular sites may sometimes involve a specific surgical protocol to avoid root damage, require additional radiographic examinations, 9 and represent an obstacle to spontaneous retraction of premolars during distalization of the first molar until screws are inserted. 10 A recent meta-analysis 10 revealed that indirect skeletal anchorage showed a certain amount of anchorage loss at the premolar and incisor, whereas these side effects were avoided by those who used direct skeletal anchorage. For this reason, during recent years we have seen various modifications of distalizing appliances used in combination with paramedian miniscrews.…”

Treatment of a Class II Division 2 Malocclusion in a Teenage Patient: Clinical Case Report

“…The conventional anchoring system showed mesial premolar movement of 4.01 mm, unlike the skeletal anchorage system which did not show anchorage loss; there was a spontaneous distal movement of 2.30 mm in the premolar when direct anchorage was used. Therefore, intraoral distalizers associated with direct skeletal anchorage are a viable method to minimize the effects of anchorage loss in the treatment of Class II malocclusions [16].…”

Avaliação cefalométrica comparativa do tratamento da má oclusão de Classe II com o distalizador first class em ancoragem convencional e esquelética e aparelho extrabucal cervical seguidos de aparelho fixo

“…Estudos recentes se propuseram a combinar os diferentes aparelhos distalizadores com ancoragem em mini-implantes (ESCOBAR et al, 2007;GELGOR et al, 2004;SEZEN, 2003;KINZINGER et al, 2008;KIRCELLI, 2006;KYUNG et al, 2003;OBERTI et al, 2009;ÖNÇAĞ et al, 2007;LEE;KWON, 2005;TSUBONO, 2005), mostrando resultados animadores, pois não houve perda de ancoragem (GREC et al, 2013).…”