title: Extraoral vs intraoral appliance for distal movement of maxillary first molars: a randomized controlled trial.
abstract: Using randomized controlled trial methodology, the aim of this study was to evaluate and compare the treatment effects of an extraoral appliance (EOA) and an intraoral appliance (IOA) for distal movement of maxillary first molars. A total of 40 patients (mean 11.5 years, SD 1.29) at the Orthodontic Clinic, National Health Service, Skane County Council, Malmö, Sweden, were randomized to receive treatment with either extraoral traction (cervical headgear) or an IOA using superelastic coils for distal movement of maxillary first molars. The inclusion criteria were a nonextraction treatment plan, a Class II molar relationship and maxillary first molars in occlusion with no erupted maxillary second molars. The outcome measures to be assessed in the trial were treatment time, cephalometric analysis of distal molar movement, anterior movement of maxillary central incisors, ie, anchorage loss and sagittal and vertical skeletal positional changes of the maxilla and mandible. In the IOA group, the molars were distalized during an average time of 5.2 months, whereas in the EOA group the corresponding time was 6.4 months (P < .01). The mean amount of distal molar movement was significantly higher in the IOA than in the EOA group, three mm vs 1.7 mm (P < .001). Moderate anchorage loss was produced with the IOA implying increased overjet (0.9 mm) whereas the EOA created decreased overjet (0.9 mm). It can be concluded that the IOA was more effective than the EOA to create distal movement of the maxillary first molars.
authors.affiliation: Department of Orthodontics, Faculty of Orthodontics, Malmö University, Malmö, Sweden. lars.bondemark@od.mah.se
authors.forename: Lars
authors.initials: L
authors.lastname: Bondemark
authors.forename: Ingela
authors.initials: I
authors.lastname: Karlsson
mesh_terms: D002508:Cephalometry; D002648:Child; D003799:Dental Stress Analysis; D005115:Extraoral Traction Appliances; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D008437:Maxilla; D008963:Molar; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D009969:Orthodontic Wires; D013997:Time Factors; D014087:Tooth Movement Techniques / Q000295:instrumentation*; D016896:Treatment Outcome