title: Midpalatal miniscrews and high-pull headgear for anteroposterior and vertical anchorage control: cephalometric comparisons of treatment changes.
abstract: BACKGROUND
  Our aim was to evaluate which anchorage system is better suited for both anteroposterior and vertical anchorage control of maxillary posterior teeth.
  
  
  METHODS
  Fifty-one subjects requiring maximum anchorage were divided into 2 groups according to maxillary posterior anchorage reinforcement: high-pull headgear, conventional transpalatal arch, and interarch elastics (n = 28); or modified transpalatal arch supported by 2 midpalatal miniscrews (n = 23). Bilateral maxillary first premolars were extracted in all patients. Pretreatment and posttreatment lateral cephalometric radiographs were superimposed to compare skeletal and dental changes between the groups.
  
  
  RESULTS
  (1) The miniscrew group had less mesial movement of the maxillary first molars (0.85 vs 3.63 mm) and greater maxillary incisor retraction (6.87 vs 4.50 mm) than did the headgear group with the same treatment duration. (2) The maxillary molars were significantly intruded in the miniscrew group (1.30 mm), whereas they were extruded in the headgear group (0.71 mm). In the miniscrew group, intrusion of the maxillary molars resulted in a statistically significant decrease in the mandibular plane angle (0.80°). Patients using high-pull headgear showed no significant decrease in these measurements.
  
  
  CONCLUSIONS
  In both the anteroposterior and vertical directions, a modified transpalatal arch supported by 2 midpalatal miniscrews provided more stable anchorage.
authors.affiliation: Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan. bluchip7@gmail.com
authors.forename: Jungkil
authors.initials: J
authors.lastname: Lee
authors.forename: Ken
authors.initials: K
authors.lastname: Miyazawa
authors.forename: Masako
authors.initials: M
authors.lastname: Tabuchi
authors.forename: Misuzu
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Momoko
authors.initials: M
authors.lastname: Shibata
authors.forename: Shigemi
authors.initials: S
authors.lastname: Goto
mesh_terms: D059925:Anatomic Landmarks / Q000473:pathology; D001641:Bicuspid / Q000601:surgery; D001863:Bone Screws; D002508:Cephalometry / Q000379:methods*; D002680:Chin / Q000473:pathology; D005115:Extraoral Traction Appliances; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D008311:Malocclusion, Angle Class I / Q000628:therapy; D008312:Malocclusion, Angle Class II / Q000628:therapy; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000473:pathology; D008963:Molar / Q000473:pathology; D009295:Nasal Bone / Q000473:pathology; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D010159:Palate / Q000601:surgery*; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology; D014081:Tooth Extraction; D014087:Tooth Movement Techniques / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014716:Vertical Dimension; D055815:Young Adult