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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

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Open Access 01-11-2021 | Original Article

Efficiency of the skeletonized Pendulum K appliance for non-compliance maxillary molar distalization

A clinical pilot study

Authors: Gero Stefan Michael Kinzinger, Jan Hourfar, Univ.-Prof. Dr. Jörg Alexander Lisson

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 6/2021

Abstract

Purpose

Conventional anchorage with exclusively intraorally anchored appliances for non-compliance molar distalization combines a palatal acrylic button with periodontal anchorage. This type of anchorage is critically discussed because of the temporary hygienic impairment of the palate and the uncertain anchoring quality of the button. A purely dentally/periodontally anchored Pendulum K appliance was developed, which is exclusively anchored via four occlusal rests. The aims of this pilot study were to examine the suitability of the skeletonized Pendulum K for distalization of maxillary molars, and to investigate the quality of this alternative anchoring modality.

Patients and methods

In all, 10 patients received skeletonized Pendulum K appliances attached to all maxillary premolars for bilateral molar distalization. Supporting anchorage through an acrylic button adjacent to the anterior palate was not used. The pendulum springs were initially activated on both sides with a distalization force of 220 cN each and provided with uprighting and toe-in bends. The specific force/moment system was regularly reactivated intraorally by adjustment of the distal screw.

Results

The study demonstrates the suitability of the skeletonized Pendulum K appliance for the distalization of maxillary molars (3.28 ± 0.73 mm). Side effects on the molars were slight distal tipping (3.50 ± 2.51°/PP, 3.00 ± 1.41°/SN) and mesial inward rotation (average 2.75 ± 7.50° and 4.50 ± 12.77°). Significant anchorage loss occurred in the form of mesialization of the incisors by 1.40 ± 0.82 mm and of the first premolars by 2.28 ± 0.85 mm.

Conclusion

The skeletonized Pendulum K appliance allows compliance-free upper molar distalization. Exclusively dental/periodontal anchorage resulted in a lower percentage of molar distalization compared to a conventional anchoring preparation of the Pendulum K with a palatal acrylic button. Anchorage loss had a comparatively stronger effect on the anchoring premolars but less on the incisors. Typical side effects on the molars such as distal tipping and mesial inward rotation were remarkably low.

Angelieri F, Almeida RR, Almeida MR, Fuziy A (2006) Dentoalveolar and skeletal changes associated with the pendulum appliance followed by fixed orthodontic treatment. Am J Orthod Dentofacial Orthop 129:520–527CrossRef

Bussick TJ, McNamara JA Jr. (2000) Dentoalveolar and skeletal changes associated with the pendulum appliance. Am J Orthod Dentofacial Orthop 117:333–343CrossRef

Byloff FK, Darendeliler MA (1997) Distal molar movement using the pendulum appliance. Part 1: clinical and radiological evaluation. Angle Orthod 67:249–260PubMed

Byloff FK, Darendeliler MA, Clar E, Darendeliler A (1997) Distal molar movement using the pendulum appliance. Part 2: the effects of maxillary molar root uprighting bends. Angle Orthod 67:261–270PubMed

Chaques-Asensi J, Kalra V (2001) Effects of the pendulum appliance on the dentofacial complex. J Clin Orthod 35:254–257PubMed

Chiu PP, McNamara JA Jr., Franchi L (2005) A comparison of two intraoral molar distalization appliances: distal jet versus pendulum. Am J Orthod Dentofacial Orthop 128:353–365CrossRef

Dahlberg G (1940) Statistical methods for medical and biological students. Interscience Publications, New York

Diedrich P (1993) Verschiedene orthodontische Verankerungssysteme. Fortschr Kieferorthop 54:156–171CrossRef

Fuhrmann R, Wehrbein H, Diedrich P (1994) Anterior anchorage quality of a modified nance-appliance during molar distalization. Kieferorthopäde 8:45–52

10.

Fuziy A, Rodrigues de Almeida R, Janson G, Angelieri F, Pinzan A (2006) Sagittal, vertical, and transverse changes consequent to maxillary molar distalization with the pendulum appliance. Am J Orthod Dentofacial Orthop 130:502–510CrossRef

11.

Ghosh J, Nanda RS (1996) Evaluation of an intraoral maxillary molar distalization technique. Am J Orthod Dentofacial Orthop 110:639–646CrossRef

12.

Hilgers JJ (1992) The pendulum appliance for class II non-compliance therapy. J Clin Orthod 26:706–714

13.

Hourfar J, Ludwig B, Wilhelmy B, Kinzinger G, Ruf S (2013) Molarendistalisation mit dem skelettal verankerten Pendulum K. Inf Orthod Kieferorthop 45:33–41CrossRef

14.

Joseph AA, Butchart CJ (2000) An evaluation of the pendulum distalizing appliance. Semin Orthod 6:129–135CrossRef

15.

Kinzinger G, Fuhrmann R, Gross U, Diedrich P (2000) Modified pendulum appliance including distal screw and uprighting activation for non-compliance therapy of class-II malocclusion in children and adolescents. J Orofac Orthop 61:175–190CrossRef

16.

Kinzinger G, Fritz U, Diedrich P (2003) Combined therapy with pendulum and lingual arch appliances in the early mixed dentition. J Orofac Orthop 64:201–213CrossRef

17.

Kinzinger G, Wehrbein H, Byloff FK, Yildizhan F, Diedrich P (2005) Innovative anchorage alternatives for molar distalization—an overview. J Orofac Orthop 66:397–413CrossRef

18.

Kinzinger G, Syree C, Fritz U, Diedrich P (2004) Molar distalization with different pendulum appliances: in vitro registration of orthodontic forces and moments in the initial phase. J Orofac Orthop 65:389–409PubMed

19.

Kinzinger G, Fritz U, Stenmans A, Diedrich P (2003) Pendulum-K-Apparaturen zur kooperationsunabhängigen Distalführung von Molaren bei Kindern und Jugendlichen – Vier Fallberichte. Kieferorthopäde 17:11–24

20.

Kinzinger G, Ludwig B, Glasl B, Lisson J (2011) Distaldrift der Prämolaren und Eckzähne nach erfolgter Molarendistalisation mit dem Pendulum K. Eine klinische Pilotstudie. Kieferorthopäde 25:167–180

21.

Kinzinger GS, Fritz UB, Sander FG, Diedrich PR (2004) Efficiency of a pendulum appliance for molar distalization related to second and third molar eruption stage. Am J Orthod Dentofacial Orthop 125:8–23CrossRef

22.

Kinzinger GS, Gross U, Fritz UB, Diedrich PR (2005) Anchorage quality of deciduous molars versus premolars for molar distalization with a pendulum appliance. Am J Orthod Dentofacial Orthop 127:314–323CrossRef

23.

Kinzinger GS, Wehrbein H, Diedrich PR (2005) Molar distalization with a modified pendulum appliance—in vitro analysis of the force systems and in vivo study in children and adolescents. Angle Orthod 75:558–567PubMed

24.

Kinzinger GS, Wehrbein H, Gross U, Diedrich PR (2006) Molar distalization with pendulum appliances in the mixed dentition: effects on the position of unerupted canines and premolars. Am J Orthod Dentofacial Orthop 129:407–417CrossRef

25.

Kinzinger GS, Eren M, Diedrich PR (2008) Treatment effects of intraoral appliances with conventional anchorage designs for non-compliance maxillary molar distalization: a literature review. Eur J Orthod 30:558–571CrossRef

26.

Kinzinger GS, Diedrich PR (2007) Biomechanics of a modified pendulum appliance—theoretical considerations and in vitro analysis of the force systems. Eur J Orthod 29:1–7CrossRef

27.

Kinzinger GS, Gulden N, Yildizhan F, Diedrich PR (2009) Efficiency of a skeletonized distal jet appliance supported by miniscrew anchorage for noncompliance maxillary molar distalization. Am J Orthod Dentofacial Orthop 136:578–586CrossRef

28.

Ludwig B, Glasl B, Kinzinger G, Lisson J (2009) Skelettales K‑Pendulum – eine rein skelettal verankerte, compliance-unabhängige Apparatur zur Molarendistalisation im Oberkiefer. Inf Orthod Kieferorthop 41:129–137CrossRef

29.

Önçağ G, Seçkin Ö, Dinçer B, Arikan F (2007) Osseointegrated implants with pendulum springs for maxillary molar distalization: a cephalometric study. Am J Orthod Dentofacial Orthop 131:16–26CrossRef

30.

Patel MP, Janson G, Henriques JFC, de Almeida RR, de Freitas MR, Pinzan A, de Freitas KMS (2009) Comparative distalization effects of Jones jig and pendulum appliances. Am J Orthod Dentofacial Orthop 135:336–342CrossRef

31.

Toroglu MS, Uzel I, Cam OY, Hancioglu ZB (2001) Cephalometric evaluation of the effects of pendulum appliance on various vertical growth patterns and of the changes during short-term stabilization. Clin Orthod Res 4:15–27CrossRef

Title: Efficiency of the skeletonized Pendulum K appliance for non-compliance maxillary molar distalization
A clinical pilot study
Authors: Gero Stefan Michael Kinzinger
Jan Hourfar
Univ.-Prof. Dr. Jörg Alexander Lisson
Publication date: 01-11-2021
Publisher: Springer Medizin
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 6/2021
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI: https://doi.org/10.1007/s00056-021-00280-8

At a glance: The STEP trials

Springer Medicine

Efficiency of the skeletonized Pendulum K appliance for non-compliance maxillary molar distalization

A clinical pilot study

Abstract

Purpose

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

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