Non-compliance maxillary molar distalizing appliances : an overview of the last decade

To perform a literature review focusing on the use of non-compliance intraoral appliances for molar distalization therapy.A literature search ranged from January 1999 to December 2009 in order to describe dento-alveolar changes and skeletal vertical modifications following the use of conventional anchorage intraoral distalizing appliances. The quality of the retrieved studies was ranked on a 12-points scale, from low to high quality.A total of 214 articles were found and only 24 were considered eligible for the critical examination. Maxillary first molar distalization ranged from 6.4mm to 0.5mm with a concomitant distal tipping from 18.5° to bodily distalization. A smaller amount of distal movement and a greater amount of crown tipping can be noted at second molars. Premolar anchorage loss and incisor proclination represent an unavoidable side-effect and ranged from 4.33 mm to 0.73 mm and from 13.7° to 0.6° respectively. Skeletal vertical modifications were noted. Increase in vertical facial dimension ranged from 1.5° to -1.8° and lower anterior facial height ranged from an increase of 3.2 to a decrease of 0.6 mm. The assessment of study quality showed that 19 studies were of low quality, 3 of medium quality and 2 of medium-high quality.Maxillary molar distalization can be effectively performed with the use of noncompliance intraoral appliances. As a consequence, premolar anchorage loss, incisor proclination and a slight increase in vertical facial dimension can occur. Because of the lack of high-quality studies the findings of this review should be carefully interpreted.