Comparing Distal-Jet with Dental Anchorage to Distal-Jet with Skeletal Anchorage: A Prospective Parallel Cohort Study

Abstract

The use of traditional intra-oral devices in maxillary molar distalization is not without undesirable consequences. The aim of the present study was to compare the miniscrew-supported distal-jet appliance to a traditional distal-jet appliance by evaluating the amount of upper first molar distalization and the dentoalveolar side effects. Data of 600 subjects visited at the orthodontic unit of Sapienza University of Rom were analyzed. Only 46 patients met the inclusion criteria and were selected and treated. Subjects were assigned randomly to receive treatment either with miniscrew-supported distal-jet appliance (Group A) or with a traditional distal-jet appliance (Group B). In Group A, miniscrews were inserted using a computer-guided surgical guide. The amount of upper first molar distalization and the dentoalveolar side effects were assessed both on the digital casts and on the lateral cephalometric radiograph at the end of the distalization phase. A descriptive statistical analysis that included the mean values and the standard deviation was conducted to evaluate the molar distalization and the dentoalveolar effects in two groups. Intergroup differences were determined using the Student’s t-test. The significance was set at p ≤ 0.05. In Group A, greater maxillary first molar distalization and a spontaneous distalization of the first premolars and a palatal inclination of central incisors were observed. By contrast, in Group B, the first premolars tipped mesially and a proclination of the maxillary central incisors was observed. In both groups, the transverse widths of the dental arch increased while a greater tendency of first premolar extrusion and of maxillary first molar rotation was observed in Group B. The skeletal anchorage device achieved greater first molar distalization and did not cause dento-alveolar side effects.

Eficacia de los alineadores dentales versus ortodoncia convencional en movimientos de extrusión. Revisión de literatura

“…Por su parte, en un estudio comparativo de la ortodoncia convencional realizado por Altieri et al (28) entre aparatología interdental con minitornillo y la ortodoncia tradicional, se evidenció que en el segundo existió una extrusión promedio de 1,1 mm + 0,8 en referencia de la distalización del primer molar superior. En cambio, para Garnett et al (13) en un estudio sobre los alineadores transparentes, la extrusión de los incisivos superiores e inferiores fue menor a 1mm.…”

Evaluation of Palatal Bone Thickness at the Implantation Areas of Two Popular Bone-Anchored Distalizers—A Cone Beam Computed Tomography Retrospective Study

“…It also minimized the need for patient cooperation in terms of wearing extraoral appliances or intermaxillary elastics commonly recommended as a method of anchorage reinforcement [1]. Molar distalization requires special attention in the context of maintaining anchorage as, regardless of the method used, in most cases, traditional intraoral distalizers lead to an undesirable proclination of the teeth from the anterior anchor unit [2][3][4][5][6][7][8]. Moreover, distalization is frequently associated with adverse effects in the vertical plane such as molar extrusion and an increase in the lower facial height [9][10][11].…”

Clinical Experience and Digital Knowledge in Virtual Planning of Palatal Orthodontic Miniscrew Insertion

“…Sci. 2023, 13, 7474 2 of 11 Skeletal anchorage in the anterior palate is optimal for supporting various treatment mechanics, including distalization [8], rapid maxillary expansion [9], space closure [10], intrusion mechanics [11], canine disimpaction [12][13][14] and final incisor position relative to the facial profile esthetics [15,16]. Furthermore, orthodontists can address more complex clinical situations, such as severe open bite [17], impacted teeth [18] or mixed dentition [19].…”