Bilateral maxillary molar distalization by Pendex appliance

The aim of this was study to show the possibilities, indications and limitations of Pendex appliance using for upper molar distalization. A modified Pendulum appliance, with a palatal expansion screw, for bilateral upper molar distalization was applied in 40 growing patients (22 male, 18 females, with 10 years and 1 month of mean age) and in 30 adult patients (12 male, 18 females, mean age 22 years and 2 month). Were considered: the stage of molar dentition and eruption in adolescent patients, germectomy of the wisdom teeth, anchorage and the duration of treatment. Was performed an analysis of cephalograms to detect changes in sagittal plane to show the type and direction of molar distalization, the degree of molar tipping, and the reciprocal incisor protrusion. Besides were taken dental cast measurements of molar movements in the horizontal plane. Since the treatment timing of Pendex appliance was short, great skeletal changes didn’t happen, but helped to open the bite in skeletal deep-bite cases. In the sagittal plane, if the third molar had been extracted, bodily distalization of both molars was demonstrated, even when the second molar was not banded. This happened above all in adolescent , in which the best time to begin the treatment with a Pendex appliance should be before the eruption of the second molars. When first and seconds molars’ distalization was simultaneously carried out, the duration of therapy and the number of activations increased, besides a loss of anchorage was slightly greater. In horizontal plane has been observed a mesiobuccal rotation of upper molars and a vestibular drift of the unbanded second molars. The incisor protrusion was not significative, the anchorage during retraction of anterior teeth was performed very easily. The Pendex as intraoral compliance-free appliance, is an optimal device for bilateral maxillay molar distalization both in adolescent and in adult patients.