Intraoral Distalizing Devices
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An introduction to the devices that could be used for distalizing molars
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Intraoral Distalizing Devices
- 1. Intraoral Distalizing Devices Nalaka Jayaratne BDS, PhD Resident in Orthodontics, University of Connecticut School of Dental Medicine USA
- 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
- 5. Distalizing devices Extraoral • Headgear Most widely used Esthetically unacceptable Depends on patient compliance Intraoral
- 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. Intraoral appliances • Effective distalization without patient compliance • Normally use a Nance button as anchorage
- 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. 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. Pendulum
- 14. Pendulum
- 15. Pendulum • Continuous force ~ 100-200g
- 16. Pendulum • Continuous force ~ 100-200g • Distalization 2.55 – 18.5mm (SR) 4-5mm (text book)
- 19. Distal Jet
- 22. Distal Jet Large Nance button Spring (NiTi or SS) Parallel to occlusal plane 4-5mm apical to molar centroid
- 23. Distal Jet
- 24. Distal Jet Telescopic Unit Spring sliding on a 0.036” tube
- 25. Distal Jet Telescopic Unit Spring sliding on a 0.036” tube Activation Screw
- 27. Distal Jet Activation Distalization = 1.9 – 5mm http://www.perfectfinishortho.com/
- 30. Keles Slider http://www.h-s-dentaltechnik.at/ Nance button+ ABP Activation Screw
- 31. Keles Slider
- 32. Keles Slider SS wire (0.040”)
- 33. Keles Slider SS wire (0.040”) NiTi Coil Spring
- 34. Keles Slider SS wire (0.040”) NiTi Coil Spring Adjustable screw
- 35. Keles Slider SS wire (0.040”) NiTi Coil Spring Adjustable screw Distalization = 0.89 – 4mm
- 36. Jones Jig G
- 37. Jones Jig G
- 38. Jones Jig G
- 39. Jones Jig
- 40. Jones Jig Distalization = 2.85 – 4.92mm
- 42. 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
- 43. Methods • Based on the PRISMA guidelines Preferred Reporting Items for Systematic Reviews and Meta- Analyses
- 44. Methods • Based on the PRISMA guidelines
- 45. Main question • Was defined with the PICO format
- 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. 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
- 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. 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
- 50. MeSH Terms
- 51. MeSH Terms
- 52. MeSH Terms
- 53. MeSH Terms
- 54. MeSH Terms
- 57. 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
- 58. Forest plots for molar distalization with conventional anchorage
- 59. Molar distalization with skeletal anchorage
- 60. Premolar movement with conventional anchorage
- 61. Premolar movement with skeletal anchorage
- 62. 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