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Maxillary Molar Distalization with Mini-screw Implant Supported Appliances Maschos Papadopoulos. AAO June 2021. Episode 118

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Farooq Ahmed

Maxillary Molar Distalization with Mini-screw Implant Supported Appliances Maschos Papadopoulos

 

Evidence

·      Laws of nature – biomechanics

o   To avoid distal tipping force should pass through COR

o   Distal force should be applied palatally: buccal can cause mucosal trauma to achieve ideal line of action

 

·      Evidence in literature

o   Systematic reviews

§  Issue miniplates, TADs and conventional implants all evaluated together

§  Different biomechanics – cannot be compared

 

·      Maschos’ systematic review distalisation using TADs – Cephalometric analysis

o   AP changes

o   1s: Both TADs and conventional appliance procline upper incisors

§  TADs Vs conventional appliance = less incisor tipping

§  Conventional appliances increase NLA

o   4s: If part of distaliser = mesial tipping, if not = distal tipping

o   6s: Distal tipping, regardless if TADs or not

·      Understanding is biomechanics more important than skeletal anchorage

§  Conventional appliances increase FMPA more than TADs

·      Undertsanding conventional appliances extrude molars

§  Less distal  with palatal TADs compared to buccal TADs and conventional appliances

 

Amda TAD supported appliance

·      Bodily movement

·      No anterior anchorage loss

 

3rd molar removal for distalisation

·      Adults remove

·      Younger patients – remain in situ

o   Moschos – removes at the end of treatment after assessment, possibly no more impacted

 

 

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