Comparative investigation of the effects of conventional and skeletal anchorage pendulum appliances on dentofacial structures.

BACKGROUND

Maxillary molar distalization is a common treatment approach for Class II malocclusions. This study aimed to compare the effectiveness and side effects of conventional pendulum appliances versus single and double miniscrew-supported pendulum appliances on skeletal and dentoalveolar structures.

METHODS

Thirty patients with skeletal Class I and dental Class II malocclusion were randomly allocated to 3 equal groups (n = 10 each): conventional pendulum appliance (Group 1), single miniscrew-supported pendulum (Group 2), and double miniscrew-supported pendulum (Group 3). Mean ages were 13.6 ± 1.2, 14.5 ± 1.1, and 14.3 ± 1.2 years, respectively. Treatment continued until bilateral Class I molar relationships were achieved. Pre- and post-distalization lateral cephalometric radiographs were analyzed for skeletal and dental changes.

RESULTS

The mean distalization period was significantly shorter in Group 3 (6.4 ± 0.5 months) compared to Group 2 (7.3 ± 0.5 months) and Group 1 (8.0 ± 0.7 months) (P < .05). All groups exhibited distal molar tipping with upper first molar long-axis angle to maxillary horizontal reference plane (°) increases of 5.2 ± 0.9°, 6.8 ± 1.1°, and 7.4 ± 1.0° in Groups 1, 2, and 3, respectively. Incisor protrusion occurred in Groups 1 and 2 (upper central incisor tip to maxillary vertical reference plane (mm) increase: 2.2 ± 0.5 mm and 1.5 ± 0.4 mm), while Group 3 demonstrated incisor retrusion (-0.8 ± 0.3 mm) (P < .01). Group 3 showed significantly less increase in overjet (0.4 ± 0.2 mm) compared to Groups 1 (2.5 ± 0.6 mm) and 2 (1.7 ± 0.5 mm) (P < .01).

CONCLUSION

The double miniscrew-supported pendulum appliance demonstrated superior clinical efficiency with reduced treatment duration and minimal anchorage loss. This approach provided better control of incisor position during maxillary molar distalization compared to conventional and single miniscrew designs.