Korean J Orthod.  2017 Nov;47(6):375-383. 10.4041/kjod.2017.47.6.375.

Comparison of treatment effects between the modified C-palatal plate and cervical pull headgear for total arch distalization in adults

• Park CO
• Sa'aed NL
• Bayome M
• Park JH
• Kook YA
• Park YS
• Han SH

• KMID: 2392184
• DOI: http://doi.org/10.4041/kjod.2017.47.6.375

Abstract

OBJECTIVE
The purpose of this study was to evaluate the dental and skeletal effects of the modified C-palatal plate (MCPP) for total arch distalization in adult patients with Class II malocclusion and compare the findings with those of cervical pull headgear.
METHODS
The study sample consisted of the lateral cephalograms of 44 adult patients with Class II Division 1 malocclusion, including 22 who received treatment with MCPP (age, 24.7 ± 7.7 years) and 22 who received treatment with cervical pull headgear (age, 23.0 ± 7.7 years). Pre- (T1) and post-treatment (T2) cephalograms were analyzed for 24 linear and angular measurements. Multivariate analysis of variance was performed to evaluate the changes after treatment in each group and differences in treatment effects between the two groups.
RESULTS
The mean amount of distalization at the crown and root levels of the maxillary first molar and the amount of distal tipping was 4.2 mm, 3.5 mm, and 3.9° in the MCPP group, and 2.3 mm, 0.6 mm, and 8.6° in the headgear group, respectively. In addition, intrusion by 2.5 mm was observed in the MCPP group. In both groups, the distal movement of the upper lip and the increase in the nasolabial angle were statistically significant (p < 0.001). However, none of the skeletal and soft tissue variables exhibited significant differences between the two groups.
CONCLUSIONS
The results of this study suggest that MCPP is an effective treatment modality for total arch distalization in adults.

Keyword

Class II; Headgear; Orthodontic implant; Palatal plate

MeSH Terms

Adult*
Crowns
Humans
Lip
Malocclusion
Molar
Multivariate Analysis

Figure

• 

  Figure 1 Linear cephalometric variables used for analysis of the effects of cervical pull headgear or the modified C-palatal plate. Po, Porion; Pt, pterygoid; Or, orbitale; Sn, subnasale; UL, upper lip; LL, lower lip; FH, Frankfort horizontal plane; HRL, horizontal reference line; VRL, vertical reference line; TVL, true vertical line; 1, central incisor apex to HRL; 2, central incisor apex to VRL; 3, central incisor crown to HRL; 4, central incisor crown to VRL; 5, first molar apex to HRL; 6, first molar apex to VRL; 7, first molar crown to HRL; 8, first molar crown to VRL; 9, overjet; 10, overbite; 11, UL to TVL; 12, LL to TVL.

• 

  Figure 2 Angualr cephalometric variables used for analysis of the effects of cervical pull headgear or the modified C-palatal plate. S, Sella; N, nasion; Po, porion; Or, orbitale; FH, Frankfort Horizontal plane; PNS, posterior nasal spine; ANS, anterior nasal spine; Col, columella; A, A point; U, upper; Occ, occlusal plane point; L, lower; Go, gonion; B, B point; Me, menton; 1, SNA; 2, ANB; 3, occlusal plane angle; 4, palatal plane angle; 5, incisor mandibular plane angle (IMPA); 6, central incisor inclination; 7, first molar angulation; 8, nasolabial angle.

• 

  Figure 3 Force vectors associated with the modified C-palatal plate. The solid line shows the force vector when the most apical hook is engaged. It results in more intrusion and more root movement of the maxillary first molars compared with the other force vectors. The dashed line shows the force vector when the most occlusal hook is engaged. It may result in slight extrusion and more distal tipping compared with the other vectors. The dotted line shows the force vector when the middle hook is engaged.

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