Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents

Abstract

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.)

Sagittal correction of adolescent patients with modified palatal anchorage plate appliances

“…13,14 Recently, MPAPs have effectively distalized the entire dental arch and showed remodeling of the anterior area of the maxilla. 13,14,16,27 The changes seen in patient 1 agree with these results. Although previous studies showed that MPAPs usually result in intrusion of the maxillary first molars, 15,16 in our patient and similar to the study of Sa'aed et al, 27 the intrusion was masked by downward growth of the maxilla, resulting in extrusion of the molars.…”

“…14,16,27 The orthopedic effect of the MPAP for maxillary protraction must be verified in future studies with large samples.…”

A comparison of treatment effects of total arch distalization using modified C-palatal plate vs buccal miniscrews

“…[13][14][15] Recently, the use of the modified C-palatal plate (MCPP) for maxillary arch distalization was reported for Class II corrections in both adolescents and adults. 1,[16][17][18][19][20][21] The MCPP is a distalization appliance with a large range of action that can be easily placed without raising a flap. It also has been shown to have the capability of vertical control during distalization.…”

Three-dimensional evaluation of maxillary dentoalveolar changes and airway space after distalization in adults

“…17 Another study reported 3.1 mm of molar distalization with 1.58 of distal tipping and 1.7 mm of extrusion using the MCPP. 4 However, in the current study, the molars were distalized 3.2 mm with 3.18 of distal tipping and 1.3 mm of intrusion. These differences might be because the previous studies were performed on adolescents using a 2D evaluation method.…”

“…3 Its treatment effects, as reported by the same research group, showed significant amounts of distalization and intrusion with minimal distal tipping of the first molar. 4,5 However, accurate evaluation of the root position is very difficult to perform on two-dimensional (2D) lateral cephalograms because of superimposition and projection factors.…”