Se ha denunciado esta presentación.
Se está descargando tu SlideShare. ×

Intraoral Distalizing Devices

Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Cargando en…3
×

Eche un vistazo a continuación

1 de 62 Anuncio
Anuncio

Más Contenido Relacionado

Presentaciones para usted (20)

Similares a Intraoral Distalizing Devices (20)

Anuncio

Más de Nalaka Jayaratne (20)

Anuncio

Intraoral Distalizing Devices

  1. 1. Intraoral Distalizing Devices Nalaka Jayaratne BDS, PhD Resident in Orthodontics, University of Connecticut School of Dental Medicine USA
  2. 2. Why do we use distalizing devices? • To move molars in a distal direction Gain space Avoid extractions • Useful in treating patients with a normal mandible and a mild to moderate Class II relationship • Ideal time – Mixed dentition prior to 2nd molar eruption
  3. 3. Distalizing devices Extraoral Intraoral
  4. 4. Distalizing devices Extraoral • Headgear Intraoral
  5. 5. Distalizing devices Extraoral • Headgear Most widely used Esthetically unacceptable Depends on patient compliance Intraoral
  6. 6. Distalizing devices Extraoral • Headgear Most widely used Esthetically unacceptable Depends on patient compliance Intraoral • Pendulum and pendex appliances • Distal jet • Jones jig • Nickel-titanium coil springs • Wilson bimetric distalizing arch system
  7. 7. Intraoral appliances • Effective distalization without patient compliance • Normally use a Nance button as anchorage
  8. 8. Intraoral appliances • Effective distalization without patient compliance • Normally use a Nance button as anchorage  Insufficient to neutralize the side effects of anchorage loss
  9. 9. Intraoral appliances • Effective distalization without patient compliance • Normally use a Nance button as anchorage  Insufficient to neutralize the side effects of anchorage loss  Maxillary anterior crowding, overjet↑, tipping of premolars and canines
  10. 10. Pendulum
  11. 11. Pendulum Large Nance button
  12. 12. Pendulum Large Nance button TMA Springs (0.032”)
  13. 13. Pendulum Large Nance button TMA Springs (0.032”) Distalization = 3.81 mm
  14. 14. Pendulum
  15. 15. Pendulum • Continuous force ~ 100-200g
  16. 16. Pendulum • Continuous force ~ 100-200g • Distalization 2.55 – 18.5mm (SR) 4-5mm (text book)
  17. 17. Pendex www.northstardental.com
  18. 18. Pendex www.northstardental.com Jackscrew
  19. 19. Distal Jet
  20. 20. Distal Jet Large Nance button
  21. 21. Distal Jet Large Nance button Spring (NiTi or SS)
  22. 22. Distal Jet Large Nance button Spring (NiTi or SS) Parallel to occlusal plane 4-5mm apical to molar centroid
  23. 23. Distal Jet
  24. 24. Distal Jet Telescopic Unit Spring sliding on a 0.036” tube
  25. 25. Distal Jet Telescopic Unit Spring sliding on a 0.036” tube Activation Screw
  26. 26. Distal Jet Activation http://www.perfectfinishortho.com/
  27. 27. Distal Jet Activation Distalization = 1.9 – 5mm http://www.perfectfinishortho.com/
  28. 28. Keles Slider http://www.h-s-dentaltechnik.at/
  29. 29. Keles Slider http://www.h-s-dentaltechnik.at/ Nance button+ ABP
  30. 30. Keles Slider http://www.h-s-dentaltechnik.at/ Nance button+ ABP Activation Screw
  31. 31. Keles Slider
  32. 32. Keles Slider SS wire (0.040”)
  33. 33. Keles Slider SS wire (0.040”) NiTi Coil Spring
  34. 34. Keles Slider SS wire (0.040”) NiTi Coil Spring Adjustable screw
  35. 35. Keles Slider SS wire (0.040”) NiTi Coil Spring Adjustable screw Distalization = 0.89 – 4mm
  36. 36. Jones Jig G
  37. 37. Jones Jig G
  38. 38. Jones Jig G
  39. 39. Jones Jig
  40. 40. Jones Jig Distalization = 2.85 – 4.92mm
  41. 41. Aims of this meta-analysis • Quantify and to compare the amounts of molar distalization and anchorage loss of conventional and skeletal anchorage methods in the correction of Class II malocclusion with intraoral distalizers
  42. 42. Methods • Based on the PRISMA guidelines Preferred Reporting Items for Systematic Reviews and Meta- Analyses
  43. 43. Methods • Based on the PRISMA guidelines
  44. 44. Main question • Was defined with the PICO format
  45. 45. Main question • Was defined with the PICO format PICO format Question Population Subjects with Class II malocclusion Intervention Intraoral distalizers with conventional anchorage Comparison Intraoral distalizers with skeletal anchorage Outcome Efficiency in the correction of Class II malocclusion
  46. 46. Main question • Was defined with the PICO format PICO format Question Population Subjects with Class II malocclusion Intervention Intraoral distalizers with conventional anchorage Comparison Intraoral distalizers with skeletal anchorage Outcome Efficiency in the correction of Class II malocclusion
  47. 47. Search strategy Database Key words Limits PubMed Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization English language; humans, 1970 to September 2010 Embase Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization Only English; humans, 1970 to September 2010 Web of Science Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization English language; only articles (not reviews, letters, abstracts, meetings, and editorials);1970 to September 2010 Scopus Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization English language; only articles (not reviews, letters, abstracts, meetings, and editorials);1970 to September 2010 Cochrane Library Distalizers; distalization and appliance; orthodontic and distalization; noncompliance and appliances, first and molar and distalization; upper and molar and distalization; maxillary and molar and distalization
  48. 48. Search strategy Database Key words Limits PubMed Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization English language; humans, 1970 to September 2010 Embase Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization Only English; humans, 1970 to September 2010 Web of Science Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization English language; only articles (not reviews, letters, abstracts, meetings, and editorials);1970 to September 2010 Scopus Distalizers OR distalization appliance OR orthodontic distalization OR noncompliance appliances OR first molar distalization OR upper molar distalization OR maxillary molar distalization English language; only articles (not reviews, letters, abstracts, meetings, and editorials);1970 to September 2010 Cochrane Library Distalizers; distalization and appliance; orthodontic and distalization; noncompliance and appliances, first and molar and distalization; upper and molar and distalization; maxillary and molar and distalization
  49. 49. MeSH Terms
  50. 50. MeSH Terms
  51. 51. MeSH Terms
  52. 52. MeSH Terms
  53. 53. MeSH Terms
  54. 54. Meta-Analysis • Articles divided into 2 groups Conventional or skeletal no distinction between different types of distalizers • Only articles of medium and high quality were included
  55. 55. Forest plots for molar distalization with conventional anchorage
  56. 56. Molar distalization with skeletal anchorage
  57. 57. Premolar movement with conventional anchorage
  58. 58. Premolar movement with skeletal anchorage
  59. 59. Conclusions • There was scientific evidence that both anchorage systems are effective for distalization • However, with skeletal anchorage, there was no anchorage loss when direct anchorage was used

×