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
