Treatment effects of mandibular total arch distalization using a ramal plate

Abstract

ObjectiveThe purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms.MethodsPre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, 23.9 ± 5.52 years) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001.ResultsThe mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001).ConclusionsThe mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.

Class III malocclusion camouflage treatment in adults: A Systematic Review

“…Of the nine included studies, eight were retrospective cohort and one was retrospective case-control [2,[6][7][8][9][10][11][12][13]. No prospective studies, randomized or not, satisfying the inclusion criteria were found.…”

“…One study included patients treated with and without extractions in the same group [7]. No extraction approaches were implemented in four studies [2,[11][12][13] and included distalization of the mandibular dentition, associated or not with Class III intermaxillary elastics. One study used high-pull Jhook headgear to the mandibular arch to correct the malocclusion [11].…”

“…Temporary anchorage devices (TADs) were used in three studies [2,12,13]. He et al associated the MEAW (Multiloop Edgewise Archwire) technique with maxillary mini-implants and modified Class III elastics [2].…”

“…Yu et al performed distalization of the mandibular dentition using ramal plates. Nakamura et al associated TADs and coil springs or elastic chains [12,13]. The high heterogeneity presented by the selected studies, especially regarding the treatment approaches, prevented performing a meta-analysis.…”

“…Camouflage treatment can be carried out by different approaches and may include teeth extractions, distalization of the mandibular dentition, and use of Class III intermaxillary elastics [2,[6][7][8][9][10][11][12][13]. Different approaches result in different outcomes and an overview of the effects of camouflage treatment in adults is not available as a systematic review.…”