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Maxillary molar distalisation using palatal TAD-supported devices in the treatment of Class II malocclusion: a systematic review Cover

Maxillary molar distalisation using palatal TAD-supported devices in the treatment of Class II malocclusion: a systematic review

Open Access
|Jul 2022

Figures & Tables

Figure 1.

Flow diagram of the included studies according to the PRISMA scheme.

Characteristics of the included studies_

Author (year)Study design/Sample sizeAverage age in years (M/F)Assessment methodMolar distal movement (mm)Molar distal tipping (°)Premolar mesial movement (mm)Premolar mesial tipping(°)Mean treatment durationDistalization rateDistalizing appliance (N° of miniscrews)TAD’s lenght(L) and diameter (D)Skeletal anchorage siteApplied distalization force
Cassetta (2019)Prospective (case control)/1013.1 (-/-)Lateral cephalograms + Digital cast models5.300.01-4.30-7.706.0 months0.88 mm/monthTAD-supported distal jet appliance (2)D = 2.5 mmL = 8.5 mmParamedian area of the anterior palateCoil spring compressed with a force of 250N (200–400g)
Jo (2018)Retrospective/2022.4 (4M/16F)Lateral cephalograms3.972.93--25.8 months0.15 mm/monthModified C-palatal plate (3)D = 2 mmL = 8 mmParamedian area of the midpalatal suture300g/side
Kircali (2018)-/2014.05 (7M/13F)Lateral cephalograms + Dental cast models4.208.90-2.20-3.408.4 months0.50 mm/monthTAD-anchored pendulum appliance (1)D = 1.9 mmL = 9 mmParamedian area of the anterior palate250g/side
Lee (2018)Retrospective/2221.9 (-/-)Lateral cephalograms4.202.00----Modified C-palatal plate (3)D = 2 mmL = 8 mmParamedian palate300g/side
Cambiano (2017)Retrospective/1814.0 (4M/14F)Lateral cephalograms3.4511.24-1.650.464.8 months0.72 mm/monthBone-anchored pendulum appliance (2)D = 2.4 mmL = 14 mmParamedian area of the anterior palate250g
Park (2017)-/2224.7 (6M/16F)Lateral cephalograms4.223.85--29.9 months0.14 mm/monthModified C-palatal plate (3)D = 2 mmL = 8 mmParamedian palate300g/side
Duran (2016)Prospective/2113.6 (12M/9F)Digital cast models4.1011.02-2.90-6.215.3 months1.02 mm/monthHyrax screw (2)D = 1.7 mmL = 8 mmAnterior palateThe screw was activated by 0.2 mm every 5 days
Kook (2014)Retrospective/2022.9 (7M/13F)CBCT’s derived cephalograms3.303.42-3.05-8.3812.5 months0.30 mm/monthModified palatal anchorage plate (3)D = 2 mmL = 8 mmParamedian palate300g/side
Nienkemper (2014)Retrospective/A: 23 B: 14A: 13.7(12M/11F) B: 30.9(4M/10F)Lateral cephalogramsA: 3.70B: 3.30A: 2.40 - B: -1.20 -- 7.5 monthsA: 0.50 mm/month B: 0.44 mm/monthBeneslider (2)D = 2 mmL = 9 mm/11 mmMedian area of the anterior palate5N (510g)
Kaya (2013)Retrospective/2014.3 (5M/10F)Lateral cephalograms3.008.80-1.83-6.108.1 months0.37 mm/monthImplant-supported pendulum (2)D = 2 mmL = 8 mmParamedian area of the anterior palate230g/side
Suzuki (2013)-/2023.2 (8M/12F)Lateral cephalograms + Dental cast models4.504.10--3.2 months1.40 mm/monthiPanda (2)D = 1.6L = 6Midpalatal suture1N (102g)

Methodologic quality scoring protocol (maximum score, 9 points)_

Study design
    3 points: randomized clinical trial
    2 points: randomization process not well described or controlled prospective study
    1 point: uncontrolled prospective study
    0 point: retrospective study or not mentioned
Sample size
    1 point: larger than or equal to 15 subjects
    0 point: less than 15 subjects
Sample description
    2 points: description of all 3 items (age, sex, mean treatment duration)
    1 point: only 2 items described
    0 point: only 1 item described
Error analysis
    1 point: error analysis value cited
    0 point: error analysis value not cited, or error analysis not performed
Statistical analysis
    2 points: adequate
    1 point: partially adequate
    0 point: no statistical tests conducted

Search strategy_

Search strategy for Pubmed
  • Micro-implant OR “micro implant” OR “micro implants”

  • Mini-implant OR “mini implant”

  • “Orthodontic implant”

  • Mini-plate OR “mini plate”

  • “Palatal implant” OR “midpalatal implant”

  • Miniscrew OR mini-screw OR “mini screw”

  • Microscrew OR micro-screw OR “micro screw”

  • 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7

  • Orthodontic

  • Distalizers OR “distalization appliance” OR “orthodontic distalization” OR “noncompliance appliances” OR “first molar distalization” OR “upper molar distalization” OR “maxillary molar distalization”

  • 8 AND 9 AND 10

Search strategy for CENTRAL
  • (maxillary OR upper) AND (“molar distalization” OR distalization)

  • (“Class II”) AND (“Temporary anchorage device” OR TAD OR TADs)

  • (“Class II”) AND (miniscrew OR “mini screw” OR miniimplant OR “mini implant”)

  • 1 AND 2

  • 1 AND 3

Search strategy for Scopus and for Web of Knowledge
  • (maxillary OR upper) AND (“molar distalization” OR distalization)

  • (“Class II”) AND (“Temporary anchorage device” OR TAD OR TADs)

  • (“Class II”) AND (miniscrew OR “mini screw” OR miniimplant OR “mini implant”)

  • 1 AND 2

  • 1 AND 3

Assessment of the study quality_

Author (year)Study design 0–3Sample size 0–1Sample description 0–2Method error analysis 0–1Adequacy of statistical analysis 0–1Quality score 0–9Quality standard
Cassetta (2019)201014Medium
Jo (2018)012025Medium
Kircali (2018)012025Medium
Lee (2018)010124Medium
Cambiano (2017)012126Medium
Park (2017)012025Medium
Duran (2016)112127High
Kook (2014)012126Medium
Nienkemper (2014)012025Medium
Kaya (2013)012126Medium
Suzuki (2013)012014Medium
DOI: https://doi.org/10.2478/aoj-2022-0023 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 202 - 212
Submitted on: Mar 1, 2022
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Accepted on: May 1, 2022
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Published on: Jul 6, 2022
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2022 Gianluigi Fiorillo, Alessandra Campobasso, Giorgio Mariani, Eleonora Lo Muzio, Gualtiero Mandelli, Giorgio Gastaldi, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.