Maxillary molar distalization: Pendulum and Fast-Back, comparison between two approaches for Class II malocclusion

To compare the dento-alveolar and skeletal effects produced by two different molar intraoral distalization appliances, Pendulum and Fast-Back, both followed by fixed appliances, in the treatment of Class II malocclusion.

41 patients for Pendulum (18 males and 23 females) and 35 for Fast-Back (14 males and 21 females) were selected, with a mean age at the start of treatment of 12.11 years in the Pendulum group and 13.3 for in the Fast-Back group. The durations of the distalization phase were 8 months in the Pendulum group and 9 months in the Fast-Back group, and the durations of the second phase of treatment with fixed appliances were 19 months in the Pendulum group and 20 months in the Fast-Back group. Lateral cephalograms were analyzed at 3 observation times: before treatment, after distalization and after comprehensive orthodontic treatment.

During molar distalization the Pendulum subjects showed greater distal molar movement and less anchorage loss at both the premolars and maxillary incisors than the Fast-Back subjects. Pendulum and Fast-Back produced similar amounts of distal molar movement and overcorrection of molar relationship at the end of distalization though the Fast-Back induced a more bodily movement. Very little change occurred in the inclination of the mandibular plane at the end of the 2-phase treatment in both groups. At the end of treatment the maxillary first molars were on average 1mm more distal in the Pendulum group compared to the Fast-Back group, while the total molar correction was 3.2mm with 3.9° of distal inclination for the Pendulum and 2mm with 1.1° of mesial inclination for the Fast-Back. Both appliance were equally effective in inducing a satisfactory Class I relationship in 97.2% of the cases.

The Pendulum and the Fast-Back induce similar dentoskeletal effects. The use of the two distalization devices, therefore, can be considered clinically equivalent.