Mandibular molar protraction: A comparison between fixed functional appliances and temporary anchorage devices

This study aimed to compare the efficiency of temporary anchorage devices (TADs) and fixed functional appliances (FFAs) for mandibular molar protraction.

Orthodontic records of 1050 consecutively treated patients with molar protraction were screened. Thirty-six records (22 females and 14 males; mean age, 17.4 years) were divided into two groups: TAD (21 subjects with 25 edentulous spaces) and FFA (15 subjects with 24 edentulous spaces). The primary outcome measure was the efficiency of protraction [magnitude and time required for protraction (rate) and anchor loss (AL)]. The secondary outcomes involved measuring the type of tooth movement (TOTM), external apical root resorption (EARR), alveolar bone height change (ABHC), alveolar bone width change (ABWC) and appliance failure.

The rate of tooth movement was significantly higher for FFAs (0.83 ± 0.35 mm/month) versus TADs (0.49 ± 0.2 mm/month) (P = .005). Total treatment duration was less for FFAs (34.78 ± 8.1 months) versus TADs (47.72 ± 13.94 months) (P = .002). TOTM was similar for both (P = .909). EARR was 1.42 ± 1.38 mm for TAD and 1.25 ± 0.88 mm for FFA (P = .81). ABHC increased in the FFA group (1.01 ± 3.62 mm) and decreased for the TAD group (0.68 ± 1.66 mm). ABWC increased for both TAD (1.81 ± 1.73 mm) and FFA (1.75 ± 1.35 mm). The failure rate was 50% for FFAs and 33% for TADs.

Both systems provided translation of lower molars with comparable anchorage control. However, FFAs were more efficient than TADs for lower molar protraction.