Maxillary molar distalization using conventional versus skeletal anchorage devices: A systematic review and...

The purpose of this study was to systematically review the evidence regarding conventional versus skeletal anchorage devices for molar distalization.

An electronic search was conducted. Hand searching was done in the reference lists of included studies and some journals. Studies comparing conventional and skeletal anchorage for molar distalization in Angle class I or II malocclusions were assessed. Presence of periodontal disease, second or third molar extraction and application of tooth accelerating methods led to exclusion of studies. Generic-inverse variance approach was used for meta-analysis by use of the mean difference and random-effect model. Risk of bias was evaluated in included studies.

A total of 1996 articles were found; of which, 1991 were excluded. The mean amounts of molar distalization/tipping in skeletal anchorage and conventional anchorage groups were 5.35mm/8.44° and 4.25mm/8.31°, respectively, which were not significantly different. The mean amounts of premolar movement in skeletal anchorage and conventional anchorage groups were -0.96mm and +2.21mm, respectively, which was statistically significant (P=0.004). Duration of treatment in skeletal anchorage and conventional anchorage groups was 8.23 months and 7.95 months, respectively, which were significantly different (P=0.0001). Risk of bias was assessed to be high.

The conventional and skeletal anchorage devices were not significantly different in terms of the amount of molar distalization/tipping. However, the anchorage loss was lower in the skeletal anchorage group. The treatment time was shorter in the conventional anchorage group. More studies with proper design are required.