Anchorage quality of deciduous molars versus premolars for molar distalization with a pendulum appliance

The aim of this study was to assess dental anchorage qualities when the pendulum appliance is used for distal molar movement.

Thirty adolescents in various dentition stages received a modified pendulum appliance with a distal screw and a specially preactivated pendulum spring for bilateral molar distalization in the maxilla. The subjects were subcategorized into 3 groups of 10 according to the dental anchorage used: deciduous molars, premolars and deciduous molars, or only premolars. Dentoalveolar effects and side effects in the anchorage unit and in the molar area were determined by cephalometric analysis.

Statistical analysis of the measurements showed significant differences between groups in the extent of molar distalization and the resulting incisor protrusion. Distal tipping of the 6-year molars was significantly less severe (2.3 degrees +/- 1.58 degrees to the palatal plane and 2.55 degrees +/- 1.52 degrees to the anterior cranial base) in patients with premolar anchorage than in those with deciduous molar anchorage (6.15 degrees +/- 3.42 degrees and 6.35 degrees +/- 3.46 degrees ). Incisor protrusion was significantly more pronounced in patients with deciduous molar anchorage (2.75 +/- 1.4 mm) than in the other 2 groups (1.65 +/- 0.82 mm, mixed deciduous molar and premolar anchorage, and 1.75 +/- 0.75 mm, premolar anchorage). Additionally, incisor protrusion was translatory compared with controlled tipping in subjects with deciduous molar anchorage or premolar and deciduous molar anchorage.

Deciduous molars and premolars can be used for anchorage for molar distalization with a pendulum appliance; however, anchorage with premolars only results in the least pronounced dentoalveolar side effects. The anchorage quality of deciduous molar and mixed deciduous molar/premolar anchorage is limited.