Comparison of treatment effects between four premolar extraction and total arch distalization using the modified C-palatal plate

Abstract

ObjectiveThe purpose of this study was to compare the skeletal, dental, and soft-tissue treatment effects of nonextraction therapy using the modified C-palatal plate (MCPP) to those of premolar extraction (PE) treatment in adult patients with Class II malocclusion.MethodsPretreatment and posttreatment lateral cephalographs of 40 adult patients with Class II malocclusion were retrospectively analyzed. The MCPP group comprised 20 patients treated with total arch distalization of the maxillary arch while the PE group comprised 20 patients treated with four PE. Fifty-eight linear and angular measurements were analyzed to assess the changes before and after treatment. Descriptive statistics, paired t-test, and multivariate analysis of variance were performed to evaluate the treatment effects within and between the two groups.ResultsThe MCPP group presented 3.4 mm of retraction, 1.0 mm of extrusion, and 7.3° lingual inclination of the maxillary central incisor. In comparison, the PE group displayed greater amount of maxillary central incisor retraction and retroclination, mandibular incisor retraction, and upper lip retraction (5.3 mm, 14.8°, 5.1 mm, and 2.0 mm, respectively; p < 0.001 for all). In addition, the MCPP group showed 4.0 mm of distalization and 1.3 mm of intrusion with 2.9° distal tipping of the maxillary first molars.ConclusionsThese findings suggest the MCPP is an effective distalization appliance in the maxillary arch. The amount of incisor retraction, however, was significantly higher in the PE group. Therefore, four PE may be recommended when greater improvement of incisor position and soft-tissue profile is required.

Factors associated with the maxillary third molar position after total arch distalization using a modified C‐palatal plate in adolescents

“…Traditionally, several devices such as headgear and pendulum appliances have been used to distalize maxillary molars during nonextraction treatment, 1‐3 but some studies achieved successful distalization using buccal miniscrews 4‐7 . In addition, anchor plates in the zygomatic buttress and modified C‐palatal plates (MCPPs) have been reported to distalize maxillary molars 8‐16 …”

Palatal temporary skeletal anchorage devices (TSADs): What to know and how to do?

“…In addition to correction of Class II interarch relationships, sufficient distalization using TSADs, along with arch expansion and interproximal reduction, has become a major contributor to the expansion of the scope of non‐extraction treatment 53 . Palatal TSADs have two major advantages for maxillary total arch distalization compared with buccal TSADs: they are not in the pathway of tooth movement and do not need to be replaced; they provide a wide range of force application points and clinicians can conveniently attempt bodily or crown distal/root distal tipping movement 54 .…”

Validity and reliability of a trigonometry-based method for the measurement of tooth movement on digital models

“…Longitudinal evaluations of inclination and angulation between the beginning and conclusion of treatment are typically measured with the aid of lateral head films 2 - 4 or panoramic radiographs. 5 , 6 However, only incisor inclination and posterior teeth angulation can be measured using lateral radiographs, while only dental angulation can be assessed in panoramic radiographs.…”