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AlMogbel A, Alshawy ES, Alhusainy A. Efficacy of clear aligner therapy over conventional fixed appliances in controlling orthodontic movement: A systematic review. J Orthod Sci 2024; 13:23. [PMID: 38784075 PMCID: PMC11114459 DOI: 10.4103/jos.jos_176_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/10/2023] [Accepted: 01/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The purpose of the current systematic review was to answer the clinical research question "Is Clear Aligner Therapy (CAT) effective in controlling the orthodontic movement?" by bringing together the most up-to-date information about the available evidence for CAT. METHODOLOGY On January 1, 2023, a search was conducted in PubMed, ERIC, Embase, and CINHAL for any research papers published in the previous 10 years that provided an overview of the PICO questions. Both the titles and abstracts of the selected studies were evaluated independently by two different authors, and if there was any disagreement between the two review authors, a third reviewer was brought in to settle it. RESULTS Among included studies, three were retrospective non-randomized and two studies were prospective randomized clinical trials. Various authors reported better outcome for fixed orthodontic appliances than for clear aligner treatment (CAT) in relation to mandibular incisor proclination. The mean objective grading system score was better for braces (17) than for CAT (12) with no clinically significant difference, while staging had a significant impact on treatment efficacy. CONCLUSION The results of this study suggest that clear aligners may be an effective alternative to traditional braces, but more research is needed to confirm these findings and determine the optimal size of future prospective studies evaluating this treatment.
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Affiliation(s)
- AbdulMajeed AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Ebrahim S. Alshawy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Abdulmageed Alhusainy
- Department of Conservative Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
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Cheng L, Feng Z, Hao Z, Si M, Yuan R, Feng Z. Molar distalization in orthodontics: a bibliometric analysis. Clin Oral Investig 2024; 28:123. [PMID: 38286861 PMCID: PMC10824817 DOI: 10.1007/s00784-024-05520-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES The study endeavors to undertake a bibliometric analysis on molar distalization, with the objective of illuminating its evolutionary trajectory, current status, and prognosticating future research hotspots and trends. MATERIAL AND METHODS A comprehensive exploration of the literature on molar distalization was carried out by conducting a search in the Web of Science (WOS) core database of the University of Hong Kong Electronic Library. The search for topic terms employed included "molar distalization," "molar distalisation," "move molar distally," "molar distal movement," and "molar backwards." The search results were subsequently subjected to meticulous analysis using CiteSpace software. This analysis encompassed various facets such as the citation count; the geographical distribution of the countries, institutions, and journals responsible for publishing the articles; the distribution of the authors; the utilization of keywords within the articles; and the analysis of references. RESULTS A total of 516 articles were included in the analysis. The top 5 countries in terms of the number of published papers were the United States (USA), South Korea, Turkey, Italy, and Germany, and the top 5 institutions in terms of the number of published papers were Kyung Hee University, A.T. Still University of Health Sciences, Catholic University of Korea, Seoul St. Mary's Hospital, and Universidade de Sao Paulo. The top 5 authors in terms of the number of published papers were Park, Kook, Bayome, Janson, and Lee. There was little cooperation overall. The top 3 journals in terms of the most published related articles were all orthodontic-related journals. After molar distalization and anchorage, the most frequently used keywords were distalization, movement, and pendulum appliance. Kinzinger GSM is the most frequently cited author in references, and one of his articles also has the highest centrality score in references. CONCLUSIONS As the tides of time shift and scholars display an ever-growing dedication to unraveling the intricacies of this therapeutic modality, the realm of molar distalization has undergone notable advancements in technology. Initially, the traditional appliance suffered from aesthetic drawbacks and discomfort. However, contemporary iterations of the appliance have transcended these limitations, boasting enhanced elegance and convenience while concurrently elevating their efficacy. Nevertheless, limitations of current appliances, including their durability and propensity for recurrence post-treatment, continue to necessitate further advancement. Hence, the ongoing scientific inquiry aims to delve deeper into refining treatment modalities and fabricating cutting-edge appliances within this realm. CLINICAL RELEVANCE This study holds the potential to significantly enhance the ability of orthodontists to devise treatment protocols and offer state-of-the-art clinical recommendations, thereby empowering them to deliver advanced and refined orthodontic interventions.
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Affiliation(s)
- Lin Cheng
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zezhou Feng
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhaonan Hao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Minmin Si
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Rui Yuan
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhiyuan Feng
- Department of Orthodontics, Shanxi Provincial People's Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China.
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Balboni A, Cretella Lombardo E, Balboni G, Gazzani F. Vertical effects of distalization protocol with Clear aligners in Class II patients: a prospective study. Minerva Dent Oral Sci 2023; 72:291-297. [PMID: 37162331 DOI: 10.23736/s2724-6329.23.04783-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The aim of the present prospective study was to detect the effects on vertical dentoskeletal dimension produced by molar distalization with Clear Aligners in a group of subjects with Class II malocclusion. METHODS The Clear Aligners Group (CAG) comprised 20 patients (13 females, seven males) with a mean age of 17.2±3.2 years. The same standardized protocol of sequential distalization was applied in all subjects. For each patient lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). RESULTS At the end of treatment, clear aligners were effective in the correction of Class II dental relationship with the correction of the overjet (-1.3 mm). The treated group showed statistically significant reduction in FMA angle (-1.3°) associated with a counterclockwise rotation of the occlusal plane (POccl^PF -3.1°; SN^POccl -4.2°) and a slight intrusion of maxillary first molars to palatal plane (-0.9 mm). Finally, statistically significant differences were detected in anterior facial height (N-Me) and in the ArGo^GoMe angle (-1.2 mm and -3.4°, respectively). CONCLUSIONS Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the control of the occlusal plane and of the vertical dimension.
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Affiliation(s)
- Alessia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy -
| | | | - Giulia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
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Liu X, Cheng Y, Qin W, Fang S, Wang W, Ma Y, Jin Z. Effects of upper-molar distalization using clear aligners in combination with Class II elastics: a three-dimensional finite element analysis. BMC Oral Health 2022; 22:546. [PMID: 36456944 PMCID: PMC9714146 DOI: 10.1186/s12903-022-02526-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The effects of upper-molar distalization using clear aligners in combination with Class II elastics for anchorage reinforcement have not been fully investigated yet. The objective of this study is to analyze the movement and stress of the whole dentition and further explore guidelines for the selection of traction methods. METHODS Three-dimensional (3D) finite element models are established to simulate the sequential molar distalization process, including the initial distalization of the 2nd molar (Set I) and the initial distalization of the 1st molar (Set II). Each group set features three models: a control model without Class II elastics (model A), Class II elastics attached to the tooth by buttons (model B), and Class II elastics attached to the aligner by precision cutting (model C). The 3D displacements, proclination angles, periodontal ligament (PDL) hydrostatic stress and alveolar bone von Mises stress in the anterior area are recorded. RESULTS In all of the models, the maxillary anterior teeth are labial and mesial proclined, whereas the distal moving molars exhibit distal buccal inclination with an extrusion tendency. With the combination of Class II elastics, the anchorage was effectively reinforced; model C demonstrates superior anchorage reinforcement with lower stress distribution in comparison with model B. The upper canines in model B present an extrusion tendency. Meanwhile, the mandibular dentition in models B and C experience undesired movement tendencies with little discrepancy from each other. CONCLUSIONS Class II elastics are generally effective for anchorage reinforcement as the upper-molar distalization is performed with clear aligners. Class II elastics attached to an aligner by precision cutting is a superior alternative for maxillary anchorage control in cases that the proclination of upper incisors and extrusion of upper canines are unwanted.
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Affiliation(s)
- Xulin Liu
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Yuxun Cheng
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Wen Qin
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Shishu Fang
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Wei Wang
- Urumql DW Innovation InfoTech Co.Ltd, Xinjiang, 830000 China
| | - Yanning Ma
- grid.263452.40000 0004 1798 4018Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001 China
| | - Zuolin Jin
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
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Lione R, Balboni A, Di Fazio V, Pavoni C, Cozza P. Effects of pendulum appliance versus clear aligners in the vertical dimension during Class II malocclusion treatment: a randomized prospective clinical trial. BMC Oral Health 2022; 22:441. [PMID: 36217134 PMCID: PMC9552402 DOI: 10.1186/s12903-022-02483-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/28/2022] [Indexed: 11/11/2022] Open
Abstract
Background The aim of the present study was to compare the effects on vertical dentoskeletal dimension produced by Pendulum appliance and Clear Aligners in patients with Class II malocclusion.
Trial design This is a prospective two-arm parallel group randomized clinical trial with 1:1 allocation ratio. Methods The Pendulum Group (PG) consisted of 20 patients (15F, 5 M) with a mean age of 17.2 ± 4.3 years. The Clear Aligners Group (CAG) comprised 20 patients (13F, 7 M) with a mean age of 17.2 ± 3.2 years. Distalization’s protocol in PG involved the activation of TMA wires till the achievement of Class I molar relationship. A protocol of sequential distalization was applied in the CAG. For each subject lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). Descriptive statistics and statistical between-group comparisons (PG vs CAG) were calculated for the craniofacial starting forms at T1 and for the T2–T1 changes. Statistical between-group comparisons for the T2–T1 changes were performed with independent samples t-tests (P < 0.05).
Results The PG showed significantly greater increases in SN^GoGn° when compared with CAG (+ 2.1 and − 0.3 degrees, respectively). Clockwise rotation of the occlusal plane with significantly greater increase of SN^POccl angle was observed in PG (+ 2.8 degrees) when compared with CAG (− 4.2 degrees). The PG revealed a significant increase in the N-Me variable with a mean change of + 4.4 mm compared to the CAG with mean values of − 1.2 mm. The PG showed an increase in the ArGo^GoMe angle (+ 0.7° degrees) compared to the CAG (− 3.4° degrees). The PG showed significantly greater increases in both maxillary and mandibular first molar to palatal plane (+ 1.3 and + 2.1 mm, respectively) when compared with CAG (− 0.9 and − 0.2 mm, respectively).
Conclusions Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the management of the occlusal plane and vertical dimension. Trial registration: ClinicalTrials.gov, NCT05298280. Registered 28 March 2022—Retrospectively registered, https://clinicaltrials.gov.
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Affiliation(s)
- Roberta Lione
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy. .,Department of Dentistry, UNSBC, Tirana, Albania. .,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy.
| | - Alessia Balboni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Valentina Di Fazio
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Chiara Pavoni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy.,Department of Dentistry, UNSBC, Tirana, Albania
| | - Paola Cozza
- Department of Dentistry, UNSBC, Tirana, Albania.,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy
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Wang Y, Sun J, Shi Y, Li X, Wang Z. Buccal bone thickness of posterior mandible for microscrews implantation in molar distalization. Ann Anat 2022; 244:151993. [PMID: 36041697 DOI: 10.1016/j.aanat.2022.151993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/04/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study explored the inter-radicular space and buccal bone thickness of the posterior mandibular region to provide an appropriate miniscrew insertion site for lower dentition distalization. METHODS The cone-beam computed tomographic (CBCT) records of 63 subjects were collected. Buccal bone thickness (BBT) was measured at four sections: (I) the root of the second premolar(P1); (II) the mesial root of the first molar(P2); (III) the distal root of the first molar(P3); (IV) the mesial root of the second molar(P4). The narrowest inter-radicular space of the four sections was also detected. Both BBT and inter-radicular space were measured at 4 height levels, 2, 4, 6 and 8mm from the alveolar ridge. RESULTS The largest BBT was observed at the mesial root of the second molar at 6 and 8mm, demonstrating a thickness of 6.77±2.50mm and 7.46±1.94mm, respectively. It provided sufficient coverage for mini-implants inserted 10°-30° oblique to the root. Therefore, during distalization of the mandibular dentition, roots have sufficient space to bypass the inclined mini-implants on the lingual side, avoiding miniscrew-root contact. The width between the mesiodistal roots of the first molar was the smallest, showing 1.53±0.69mm and 2.13±0.65mm at 4 and 6mm. Miniscrews implanted in this region had an increased risk of root proximity. CONCLUSIONS The most appropriate insertion site at the mandibular buccal shelf was the mesial point of the second molar at 6-8mm from the alveolar ridge, and an insertion angle of 10°-30° was recommended to avoid miniscrew-root contact. CBCT analysis is recommended before implantation due to individual differences.
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Affiliation(s)
- Yaqi Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Jing Sun
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Yanli Shi
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Xin Li
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Zhiqiang Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China; Department of Orthodontics,Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 324 Jingwu Road, Jinan, Shandong, China.
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Digital Photoelastic Analysis of TAD-Supported Maxillary Arch Distalization. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12041949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The objective of this study was to determine whether the distribution of compressional and tensional stress around tooth roots is influenced by the position of a temporary anchorage device and the length of the retraction hook during the distalization of the maxillary dentition. A photoelastic orthodontic model was made of photoelastic epoxy resin. Six combinations of three retraction hook lengths and two posterior Temporary skeletal anchorage devices (TAD) positions were established. Stress was applied through an elastic chain for each of the combinations. Digital photoelastic stress analysis measured the compression, tensional stress, and direction around the tooth root. Using this novel photoelastic model, we found that the distribution of compressional and tensional stress during the retraction of the maxillary dentition was significantly influenced by the position of the TAD and the length of the retraction hook.
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Verma P, George AM. Efficacy of clear aligners in producing molar distalization: Systematic review. APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_37_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
The aim of this review is to systematically analyze the efficacy of molar distalization using clear aligners in non-growing Class II patients.
Materials and Methods:
A complete search across the electronic database through PubMed, Cochrane, Google scholar, LILACS, and manual search of orthodontic journals were done till 2019. Studies were selected on the basis of PRISMA guidelines.
Results:
A total of four articles were included in this review. The amount of molar distalization reported was 2–3 mm.
Conclusion:
Out of the four studies included. In all the studies a significant amount of distalization was reported. Three retrospective studies concluded that distalization with aligners is the most effective of all tooth movements. One study concluded that aligners effectively achieved distalization with an efficacy of 87%, other two studies concluded that aligners effectively distalized the molars with good control over vertical dimension and mesiodistal tipping.
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Affiliation(s)
- Purva Verma
- Department of Orthodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India,
| | - Ashwin Mathew George
- Department of Orthodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India,
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Beyling F, Klang E, Niehoff E, Schwestka-Polly R, Helms HJ, Wiechmann D. Class II correction by maxillary en masse distalization using a completely customized lingual appliance and a novel mini-screw anchorage concept - preliminary results. Head Face Med 2021; 17:23. [PMID: 34187487 PMCID: PMC8240392 DOI: 10.1186/s13005-021-00273-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/17/2021] [Indexed: 02/05/2023] Open
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.
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Affiliation(s)
- Frauke Beyling
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.
| | - Elisabeth Klang
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany
| | - Eva Niehoff
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.,Department of Orthodontics, Hannover Medical School (MHH), Hannover, Germany
| | | | - Hans-Joachim Helms
- Department of Medical Statistics, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Dirk Wiechmann
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.,Department of Orthodontics, Hannover Medical School (MHH), Hannover, Germany
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Bayome M, Park JH, Bay C, Kook Y. Distalization of maxillary molars using temporary skeletal anchorage devices: A systematic review and meta‐analysis. Orthod Craniofac Res 2021; 24:103-112. [DOI: 10.1111/ocr.12470] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/09/2021] [Indexed: 08/30/2023]
Affiliation(s)
- Mohamed Bayome
- Department of Preventive Dental Sciences, College of Dentistry King Faisal University Al Hofuf Saudi Arabia
- Department of Postgraduate Studies Universidad Autónoma del Paraguay Asunción Paraguay
| | - Jae Hyun Park
- Postgraduate Orthodontic Program Arizona School of Dentistry & Oral Health, A.T. Still University Mesa AZ USA
- Graduate School of Dentistry Kyung Hee University Seoul Korea
| | - Curt Bay
- Department of Interdisciplinary Health Sciences Arizona School of Health Sciences, A.T. Still University Mesa AZ USA
| | - Yoon‐Ah Kook
- Department of Orthodontics Seoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea
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Serafin M, Fastuca R, Castellani E, Caprioglio A. Occlusal Plane Changes After Molar Distalization With a Pendulum Appliance in Growing Patients with Class II Malocclusion: A Retrospective Cephalometric Study. Turk J Orthod 2021; 34:10-17. [PMID: 33828873 DOI: 10.5152/turkjorthod.2021.20050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
Objective This study aimed to evaluate the skeletal and dental changes after distalization with a pendulum appliance in growing patients with Class II malocclusion, focusing on the occlusal plane (OP). Methods The sample included 24 patients with Class II malocclusion (10 boys, 14 girls); their mean age was 12.1 years. All patients underwent molar distalization and had 2 serial cephalograms traced at baseline (T1) and after distalization (T2). Angular and linear dental changes were calculated by taking the sella-nasion (SN), palatal plane (PP), and pterygoid vertical as reference. OP inclination was compared with SN, PP, and mandibular plane. The collected data were computed for all the tested variables, and one-way paired t-test was used to assess the significance of the differences between the time points. α was set at 0.05. Multiple linear regressions were used to predict the OP changes. Results The mean total treatment time was 8±2 months to obtain a super Class I molar relationship. In T1-T2 interval, statistically significant incisor buccal tipping of 5°±3.6° (p<0.05), first molar distal tipping of 8.9°±8.3° (p<0.001), and second molar tipping of 8.2°±8.1° (p<0.001) were observed. The maxillary first and second molars moved significantly backward by 2.8±3.2 mm (p<0.05) and 3.7±2.7 mm (p<0.001), respectively. Only the premolars showed a statistically significant anchorage loss of 2.7±3.3 mm (p<0.05); overjet increased significantly at 1.3±1.2 mm (p<0.05). Regarding the OP, none of the tested variables showed any statistically significant changes between T1-T2. Conclusion The pendulum appliance showed efficacy in distalizing the maxillary first and second molars at the expense of anterior anchorage loss. The OP did not show statistically significant changes after molar distalization.
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Affiliation(s)
- Marco Serafin
- Division of Orthodontics, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | | | - Alberto Caprioglio
- Division of Orthodontics, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Reis RS, Henriques JFC, Janson G, Freitas KMS, Moura W. Dental, skeletal and soft tissue effects of the Distal Jet appliance: A prospective clinical study. Dental Press J Orthod 2020; 24:56-64. [PMID: 31994647 PMCID: PMC6986189 DOI: 10.1590/2177-6709.24.6.056-064.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 11/25/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: This study evaluated the dental, skeletal and soft tissue effects in Class II malocclusion patients treated with Distal Jet appliance, compared to an untreated control group. Methods: 44 patients with Class II malocclusion were divided into two groups: Group 1 (experimental) - 22 patients, mean age of 12.7 years, treated with the Distal Jet appliance for a mean period of 1.2 years; Group 2 (control) - 22 untreated patients, mean age of 12.2 years, followed by a mean period of 1.2 years. Lateral cephalograms were obtained before treatment (T0) and at the end of the distalization (T1).Independent t test was used to identify intergroup differences. Results: When compared to control group, the Distal Jet produced a significant increase in mandibular plane angle (0.7 ± 2.0o). The maxillary second molars presented distal inclination (6.6 ± 3.8o), distalization (1.1 ± 1.1 mm) and extrusion (1.3 ± 2.1 mm). The maxillary first molars distalized by 1.2 ± 1.4 mm. The maxillary first premolars mesialized by 3.4 ± 1.1 mm. The maxillary incisors showed slight labial tipping of 4.3 ± 4.7o and were protruded by 2.4 ± 1.7 mm. There were no significant changes in the facial profile. The overjet increased 1.5 ± 1.1 mm and overbite had no significant changes. Conclusion: The Distal Jet appliance is effective to distalize the maxillary first molars, but promotes increase in mandibular plane angle, distal inclination, extrusion and distalization of maxillary second molars, mesialization of maxillary first premolars, proclination and protrusion of maxillary incisors, and increase in overjet, when compared to a control group.
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Affiliation(s)
- Rachelle Simões Reis
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - José F C Henriques
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - Guilherme Janson
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | | | - Wilana Moura
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
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Zymperdikas VF, Yavropoulou MP, Kaklamanos EG, Papadopoulos MA. Effects of systematic bisphosphonate use in patients under orthodontic treatment: a systematic review. Eur J Orthod 2020; 42:60-71. [PMID: 31009953 DOI: 10.1093/ejo/cjz021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Bisphosphonates are a class of drugs prescribed for several osseous related disorders owing to their ability to regulate bone turnover, which could in turn affect orthodontic treatment outcomes. OBJECTIVE To examine the effect of bisphosphonate (BP) use on orthodontic patients through clinical and radiographic measurements. SEARCH METHODS Systematic and unrestricted search of 17 databases complemented with additional hand-searches were performed up to March 2019. SELECTION CRITERIA Articles reporting on human patients with a history of BPs administration that received orthodontic treatment were eligible for inclusion. DATA COLLECTION AND ANALYSIS Data regarding the medical profile of the patients, the specific type of malocclusion and the performed treatment plan, as well as the clinical and radiographic outcomes were extracted. Quality assessment was performed by the ROBINS-I tool for the cohort studies and by a slightly modified checklist from the original one proposed by Agbabiaka et al. for the case reports. RESULTS 7 articles (1 retrospective cohort study and 6 case reports) were eventually included in the present review including 122 subjects (29 patients and 93 controls) reporting on the clinical and radiographic changes following orthodontic treatment of patients during or after BPs use. BPs seem to have a controversial effect on the clinical and patient-reported variables, even though the majority of the included patients presented with compromised treatment results and a rather slow rate of tooth movement. Most radiographic findings revealed mild root resorption, widened periodontal ligament spaces and sclerotic changes on the surrounding alveolar bone. However, these results should be interpreted with caution, due to the limited number of the eligible articles and their limitations. LIMITATIONS The included studies were of rather low quality due to study design and incomplete reporting. CONCLUSIONS AND IMPLICATIONS BP administration seems to be associated with compromised clinical outcomes, prolonged treatment time, and moderate changes on the roots and surrounding tissues of orthodontic patients. REGISTRATION Non-registered. FUNDING None.
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Affiliation(s)
- Vasileios F Zymperdikas
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece.,Department of Training and Operations, Military Hospital of Thessaloniki, Greece
| | - Maria P Yavropoulou
- 1st Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Greece
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Moschos A Papadopoulos
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
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Bozkaya E, Tortop T, Yüksel S, Kaygısız E. Evaluation of the effects of the hybrid Pendulum in comparison with the conventional Pendulum appliance. Angle Orthod 2019; 90:194-201. [PMID: 31642688 DOI: 10.2319/051719-340.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the anchorage control and distalization of maxillary molars with the hybrid Pendulum appliance and to compare the results with a conventional Pendulum appliance. MATERIALS AND METHODS This study was carried out on the pre-(T0) and post-(T1) treatment lateral cephalograms and dental casts of 43 patients with Angle Class II molar relationships who were treated with conventional or hybrid Pendulum appliances. The hybrid Pendulum (HP) group consisted of 22 patients (14 females; eight males; mean age 14.3 ± 2.43 years) and treatment results were compared with a conventional Pendulum appliance (CP) group, which consisted of 21 patients (15 females; six males; mean age 14.6 ± 3.39 years). Intragroup comparisons were made with Wilcoxon test and intergroup comparisons were made with Mann-Whitney U-test (P < .05). RESULTS The mean distalization duration was 0.70 ± 0.25 years in the HP group and 0.83 ± 0.4 years in the CP group. Maxillary first molars showed significant distal movement and tipping of 4.25 mm and 9.09° in the HP group, and 3.21 mm and 9.86° in the CP group. Loss of anchorage at the first premolars was significantly smaller in the HP appliance group compared to CP group. The second premolars distalized spontaneously in the HP group while they mesialized significantly in the CP group. Proclination and protrusion of maxillary incisors were greater with the CP appliance compared to the HP appliance. CONCLUSIONS Maxillary molar distalization was achieved with both appliances. Mesialization of the anchorage unit was controlled successfully with the hybrid Pendulum; however, the conventional Pendulum appliance caused anchorage loss.
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Caruso S, Nota A, Ehsani S, Maddalone E, Ojima K, Tecco S. Impact of molar teeth distalization with clear aligners on occlusal vertical dimension: a retrospective study. BMC Oral Health 2019; 19:182. [PMID: 31409348 PMCID: PMC6692944 DOI: 10.1186/s12903-019-0880-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 08/07/2019] [Indexed: 11/24/2022] Open
Abstract
Background A common strategy in the non-extraction treatment of Class II molar relationship is maxillary molar distalization, which could increase lower face height and cause clockwise mandibular rotation. The aim of this retrospective study was to analyse the effects on vertical dentoskeletal dimension of young adults treated with sequential distalization with orthodontic aligners. Methods Lateral cephalometric radiographs of 10 subjects (8 females 2 males; mean age 22.7 ± 5.3 years) treated with upper molars sequential distalization with orthodontic aligners (Invisalign, Align Technology, San Josè, California, USA) were analyzed. Results No statistically significant difference was observed for the primary outcome SN-GoGn between T0 and T1 and it was recorded a mean variation of 0.1 ± 2.0 degrees. Statistically significant differences were found in the linear position of the upper molars (6-PP, 7-PP) the molar class relationship parameter (MR) and the upper incisive inclination (1^PP) with at least p < 0.01. Conclusions Upper molar distalization with orthodontic aligners guarantee an excellent control of the vertical dimension representing an ideal solution for the treatment of hyperdivergent or openbite subjects. It also allows an excellent control of the incisal torque without loss of anchorage during the orthodontic procedure.
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Affiliation(s)
- Silvia Caruso
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100, L'Aquila, Coppito, Italy
| | - Alessandro Nota
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100, L'Aquila, Coppito, Italy. .,Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy.
| | - Shideh Ehsani
- Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy
| | - Elena Maddalone
- Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy
| | - Kenji Ojima
- Private Practice of Orthodontics, Tokyo, Japan
| | - Simona Tecco
- Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy
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Soheilifar S, Mohebi S, Ameli N. Maxillary molar distalization using conventional versus skeletal anchorage devices: A systematic review and meta-analysis. Int Orthod 2019; 17:415-424. [PMID: 31255550 DOI: 10.1016/j.ortho.2019.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this study was to systematically review the evidence regarding conventional versus skeletal anchorage devices for molar distalization. METHOD An electronic search was conducted. Hand searching was done in the reference lists of included studies and some journals. Studies comparing conventional and skeletal anchorage for molar distalization in Angle class I or II malocclusions were assessed. Presence of periodontal disease, second or third molar extraction and application of tooth accelerating methods led to exclusion of studies. Generic-inverse variance approach was used for meta-analysis by use of the mean difference and random-effect model. Risk of bias was evaluated in included studies. RESULTS A total of 1996 articles were found; of which, 1991 were excluded. The mean amounts of molar distalization/tipping in skeletal anchorage and conventional anchorage groups were 5.35mm/8.44° and 4.25mm/8.31°, respectively, which were not significantly different. The mean amounts of premolar movement in skeletal anchorage and conventional anchorage groups were -0.96mm and +2.21mm, respectively, which was statistically significant (P=0.004). Duration of treatment in skeletal anchorage and conventional anchorage groups was 8.23 months and 7.95 months, respectively, which were significantly different (P=0.0001). Risk of bias was assessed to be high. CONCLUSION The conventional and skeletal anchorage devices were not significantly different in terms of the amount of molar distalization/tipping. However, the anchorage loss was lower in the skeletal anchorage group. The treatment time was shorter in the conventional anchorage group. More studies with proper design are required.
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Affiliation(s)
- Sepideh Soheilifar
- Hamadan university of medical sciences, dental research centre, orthodontic department, Hamadan, Iran
| | | | - Nazila Ameli
- Semnan university of medical sciences, dental school, orthodontic department, Semnan, Iran.
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Cambiano AO, Janson G, Fuziy A, Garib DG, Lorenzoni DC. Changes consequent to maxillary molar distalization with the bone-anchored pendulum appliance. J Orthod Sci 2017; 6:141-146. [PMID: 29119095 PMCID: PMC5655964 DOI: 10.4103/jos.jos_66_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES: This retrospective study aimed to evaluate the dentoalveolar, skeletal, and soft tissue effects obtained with bone-anchored pendulum appliance in patients with Class II malocclusion. MATERIALS AND METHODS: A total of 18 patients (4 male, 14 female) at a mean pretreatment age of 14.0 years (+1.08) were enrolled in this study. All patients were treated with the bone-anchored pendulum appliance for an average duration of 4.8 months. Only the active distalization period was evaluated with predistalization and postdistalization lateral cephalograms. Skeletal, dentoalveolar, and soft tissue variables were obtained. Based on these variables, the treatment effects were evaluated with dependent t-test. RESULTS: Correction of Class II molar relationship resulted from distal movement of 3.45 mm and tipping of 11.24° of the first maxillary molars. The premolars were distalized accompanying the molars. CONCLUSIONS: The bone-anchored pendulum appliance proved to be an effective method for distalization of maxillary molars in cases that require maximum anchorage, avoiding reciprocal mesial movement of premolars and incisors.
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Affiliation(s)
- Aldo Otazú Cambiano
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Brazil
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Brazil
| | - Acácio Fuziy
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Brazil
| | - Daniela Gamba Garib
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Brazil
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