CBCT Evaluation Research Articles

Evaluation of bone regeneration for augmentation of alveolar bone using 3D computer guided ceramic Sheets.

Background: This study was designed to evaluate bone augmentation of posterior alveolar mandibular ridge using 3D computer guided ceramic Sheets as a membrane in GBR . Methods: Seven patients were included in the present study. Preoperative clinical evaluation, and CBCT scan for ridge evaluation and planning, all patient clinically suffering from severed resorbed posterior alveolar ridge of the mandible. Measuring height and width of right and left residual alveolar ridge was performed in CBCT software viewer base on this digital model 3D zirconia sheet was designed and plan on patient CBCT then milled on CAD/ CAM 5 axis machine to the desired macroscopic shape. After surgery, clinical evaluations were done at intervals of 2 weeks, first month, 3rd and 6th month and directed toward the observation of the healing process, sings of inflammation, infection soft tissue dehiscence, Zr exposure or any complications of wound. 2nd surgical intervention to remove the screws and Zr sheet and CBCT evaluation to measuring alveolar ridge on both sides. Results: Results of the current showing that customized Zr sheet can use successfully to obtain vertical and horizontal bone augmentation well compatible with soft tissue without exposure. Conclusion: Customized Zr sheet act as a perfect barrier and space maintaining in GBR procedures with precise fit. Good soft tissue acceptance to Zirconia. Customized Zr sheet reduce chairing time and amount of graft. More predictable results can obtained by using xenograft under Zr sheet.

CBCT Evaluation of Changes in Root Canal Geometry Induced by the Chemical Structure of NiTi Alloys of Three Rotary Systems

Preservation of the root canal anatomy is very important for the success of endodontic treatment.Properly instrumentation of curvet root canals is influenced by flexibility of endodontic instruments which depends on composition and thermomechanical treatment of the metallic alloy. The aim of the current study was to compare the changes in root canal geometry after the preparation with two systems that work in reciprocating motion (Reciproc25, Primary Wave One) and another one in continuous rotation (One Shape), using CT measurements. Forty-five canals of extracted molars with curvatures ranging from 9 to 40 degrees were chosen for this study. The canals were divided, according to the canal curvature into three homogeneous groups and were prepared with three different rotary systems: group I with Reciproc file 25.08 (VDW, Munich, Germany), group II with Wave One Primary 25.08 (Dentsply-Maillefer Ballaigues, Switzerland) and group III with One Shape 25.06 (Micro Mega, Bensancon, France).All groups were scanned pre and post instrumentation, using NewTo 3G CBCT (QR, Italy, FOV, 0.16mm voxel size). The following parameters were assessed after measurements on cross-sectional CBCT images: the centering ability, diameter change, canal transportation. All instruments maintain the original canal curvature well, resulting in no significant differences of their centering ability (P]0.05) and canal transportation (P]0.05). The highest increase in diameter of canal was observed with Primary Wave One, which was not statistically significant for the entire canal (P]0.05). Instrumentation with Reciproc was faster than instrumentation with One Shape and Wave One,but the differences were not statistically significant (P]0.05). All systems perform safe and proper canal preparations and can be used in root canal treatment of curved canals.

The CBCT evaluation of the resorption caused by impacted canines

The CBCT evaluation of the resorption caused by impacted canines

CBCT use to Evaluate Vital Mandibular Inter-Foramin Anatomical Structures

Background: The aim of the study was to evaluate the vital anatomical structures in the mandibular inter foramin region and to investigate the presence of sexual dimorphism with respect to the left and right sides region using CBCT. Materials & Method: A total of 60 CBCT scans (30 male & 30 female) were analysed for the MF position & shape, presence and measurement of AL & MIC (both in mm), patterns of emergence of mandibular canal, symmetry of MF & AL. All the scans were taken by CS 9300 (Care stream Health India Private Limited) CBCT machine adjusted at 80 kVp, 15mA, Voxel size 0.3x0.3x0.3 and field of view (FOV) of 10x5 (mandible only). The acquired images were reconstructed into multiplane views (axial, panoramic and cross-sectional) for evaluation. Results: Position 4 of MF (below the apex of second premolar) was most common on right side while position 3 (between first & second premolar) on left side, with 75% of symmetrical MF position. The prevalence of MIC was noted in 93.75% of the patients with mean length of 12.09±5.95 mm. The prevalence of AL was 53.13% with mean length of 1.07±1.42mm. Conclusion: The present study recommends a CBCT evaluation of inter-foraminal anatomical structures before planning the placement of implants. However, no sexual dimorphism was found regarding these parameters.

CBCT Evaluation of Condylar Changes in Class II Hyperdivergent Adult Patients Following Posterior Maxillary Intrusion Using Miniscrews/Miniplates—A Prospective Study

Aim & Objectives: To evaluate using CBCT, the condylar changes taking place in retrognathic, hyperdivergent Class II adult patients following maxillary intrusion using miniscrew assembly. Materials and methods: In this prospective study design, 20 class II div I high angle cases in the age group of 20-25 years with Class II molar and canine relationship; Overjet > 5mm; ANB angle > 4°; FMA angle >25°; SNGoGn > 35°; Jaraback ratio< 60° and Lower Gonial angle>75° were taken. Each patient had a miniscrew assembly in the maxilla through which intrusive force was applied to the maxilla. Two additional miniscrews were placed between the first mandibular molars and second premolars to prevent extrusion of lower molars. CBCT images were taken at the beginning of the treatment (T1) and at the end of 6-9 months of molar intrusion (T2). Statistical analysis was carried out using student T- test. Results: Prior to treatment, the patients showed significant mandibular retrusion associated with increased maxillary posterior heights. Following maxillary intrusion with miniscrew assembly, CBCT evaluation revealed that the distance from the centre of condyle to the posterior border of the external auditory meatus was 19.2±1.67 mm on right side and 18.1±1.54mm on left side in T1 which increased to 19.6±1.45mm on right side and 18.5±1.36mm on left side in T2. The average forward displacement of condyle was .5mm which was statistically significant. The distance from the centre of condyle to superior border of external acoustic meatus was 3.1±1.7 mm on right side and 3.5 ±1.8 mm on left side in T 1 which increased to 3.8±1.9 mm on right side and 4.1 ±1.3mm on left side in T 2. The average downward displacement was .7mm which was statistically significant. Conclusion: Significant Maxillary intrusion can be achieved using miniscrews/ miniplate in adult hyperdivergent skeletal class II patients.

Can there be a more precise co-relation between grades of sinusitis, concha bullosa and deviated nasal septum- A CBCT evaluation

Computerized tomographic imaging of the nasal and paranasal regions is frequently used for sinonasal surgery. CBCT is another less explored modality which can provide accurate anatomic details. A retrograde study was done on 204 random scans to find out incidence and prevalence of sino-nasal anatomical variations and associated pathologies. A positive correlation was found between deviated nasal septum and concha bullosa. CBCT can sure act as a guide in future for sinonasal surgeries with lesser cost and radiation exposure. Keywords: CBCT, Deviated nasal septum, Choncha bullosa, Chronic sinusitis.

"Clinical and CBCT Evaluation of the Quality of Obturation and Time Efficiency of Rotary Versus Manual Instrumentation in Pediatric Endodontics"

"Clinical and CBCT Evaluation of the Quality of Obturation and Time Efficiency of Rotary Versus Manual Instrumentation in Pediatric Endodontics"

RME: effects on the nasal septum. A CBCT evaluation.

Three-dimensional images have been evaluated to study the changes that occur on the maxillary complex and the nasal septum, following rapid maxillary expansion (RME) in growing children. The records of 39 consecutively treated patients (20 male, 19 female), aged between 6.2 and 12.3 years (mean 8.6 years, S.D. 1.5), presenting a septal deviation of more than 1 mm, were analysed. Each patient was scanned at two distinct periods. The first image (T0) was obtained before treatment and hence represented the patient's baseline condition prior to expansion. The second time point (T1) was set after removal of the expander. The skeletal modifications induced by RME have been evaluated via cephalometric tracings obtained at T0 and at T1. The time lapse between T0 and T1 was 12 months. The nasal septum has been modified in its length more significantly in its lower rather than its upper tract. The width of the piriform aperture increased of 1.58 mm with an increase in the lateral walls and a downward movement of the nasal floor (consequent to an increase in septal length). There was also a reduction of septal deviation. The control group measurements did not vary during the considered period. Evidences of this study suggest that RME procedures can result in: a potentially positive effect on the nasal septum asymmetry during childhood; an increase of the nasal cavity volume due to a downward and forward movement; a lateral inclination of the nasal cavity reducing air resistance and improving breathing pattern; an increase of the length of the septum in its lower third improving its possible deviations and growth disturbances; favourable effects on the growth of the entire maxillary complex.

Microscope and micro-camera assessment of Schneiderian membrane perforation via transcrestal sinus floor elevation: A randomized ex vivo study.

We sought to assess the effectiveness of using a microscope and non-invasive camera for assessing sinus membrane perforations during transcrestal sinus floor elevation (TSFE). Five fresh human cadaver heads corresponding to eight maxillary sinuses (six bilateral and two unilateral) underwent 4 TSFEs per sinus (a total of 32 single site elevations). Each elevation was randomly assigned to receive a three or sixmm membrane elevation height (MEH). A microscope and micro-camera were used to assess the sinus membrane perforation. Afterwards, radiological and clinical membrane perforation assessments were performed. The statistical analysis results are expressed using the means, standard deviations, range values of the residual ridge height (RRH), residual ridge width (RRW), sinus membrane thickness (SMT) and incidence of perforation (IoP). Generalized linear methods were used to test for the correlation of RRH and MEH to the microscope and micro-camera perforation assessments and the correlation of microscope and micro-camera assessments with the post-operative CBCT and crestal liquid evaluation. The cumulative percentage of IoP was 40.62%, (23.07% with 3mm MEH, and 76.92% with 6mm MEH, p<0.05). The perforation assessed using either the microscope or micro-camera coincided with the post-operative CBCT and crestal liquid assessment in 87.55% sites. No significant correlation was found between the microscope or micro-camera assessments with RRH or MEH. Application of a microscope and micro-camera during transcrestal sinus floor elevation may allow the detection of the integrity of the Schneiderian membrane with greater than 85% accuracy in this ex vivo model.

CBCT evaluation of morphological characteristics of Nasopalatine canal and its related structure- A hospital based retrospective study.

Brief Background : To evaluate morphologic characteristics of Nasopalatine canal (NPC) and its relative position to Maxillary central incisor root using Cone Beam Computed Tomography. Materials and Methods: A retrospective study including 282 CBCT images divided into 5 groups: Group 1) 10 – 20 years, Group 2)21 – 30 years, Group 3)31 – 40years, Group 4)41 – 50 years, Group 5) above 51 years. The length and width of the canal were measured in sagittal section. Mesio-distal width of the canal and the distance between the Nasopalatine canal and maxillary central incisor roots at mid root (MR) and apex levels were measured in axial section. Statistical analysis was done using IBM SPSS version 21.0.Mean and standard deviation were assessed for all measurements. The significance level for all the tests was set at P &lt; 0.05. Results: The NPC length, incisive foramen width (IF) and the position of NPC to maxillary central incisor roots at midroot and apex levels showed significant difference among age groups. Gender influences NPC length, IF width, and distance of NPC to midroot of right maxillary central incisor with high statistical significance and influences Stenson’s foramen width to a certain extent (but not statistically significant). Summary and Conclusions: The NPC canal morphology showed significant variations and it is always necessary to evaluate NPC before any surgical interventions especially assessment of implant site to prevent any complications. Key Words: Maxillary central incisor, Cone Beam Computed Tomography, Tooth apex

Socket Shield and Bioactive Glass Around Anterior Maxilla Immediate Dental Implants

Introduction: This study aimed at testing the effect of the socket shield technique on the maintenance of the labial plate of bone and the change in position of its surrounding gingival soft tissues upon the immediate placement of 3 different dental implants systems, with a bone graft material filling the defects around the implants, followed by clinical and radiographic evaluation using the cone beam computed tomography after 4 and 12 months of loading.Materials and Methods: Three groups, 6 male patients each, having a failing central or lateral maxillary incisor, had their failing tooth partially extracted, with the remaining tooth half reduced to be the socket shield, then the 3 groups received 3 different dental implants systems, the Tapered Internal implant RBT Laser-Lock for group I, the Touareg-S implant for group II, and group III received the Nobel Active implant. Then, the Novabone putty bone graft was dispensed in the space between the implant and the shield and covered with a customized healing abutment. After 4 months of healing, the patients were provided with definitive restorations, and followed after 4 and 12 months for gingival recession, papillae filling the interdental spaces, and CBCT evaluation of the labial plate of bone width and vertical resorption. Each result was then statistically analyzed.Results: For all the cases in the study, no implant failed, no gingival recession was recorded, and the interdental papillae filled their spaces in most of the cases. also, no significant changes were recorded for the labial plate of bone width or height.Conclusions: The socket shield technique was able to maintain the labial plate of bone and the position of the overlying free gingival margin, with the neighboring interdental papillae showing least dimensional changes.

CBCT evaluation of condylar changes in children with unilateral posterior crossbites and a functional shift

Posterior crossbite is one of the most frequently occurring malocclusions in adolescents with a prevalence of 7% to 23%. The most common form of posterior crossbite is a unilateral posterior crossbite with a functional side shift. It has been suggested that functional posterior crossbites (FUPXB) may result in right-to-left-side differences in the condyle fossa relationship, resulting in temporomandibular joint (TMJ) problems. The objective of this study was to determine if pathological position of the condyles can cause condylar signs or symptoms like degenerative joint disease (DJD) or juvenile condylar resorption (JCR), or if the position of the condyle is just an altered position within the TMJ. Sixty patients with an average age of 9.6years were randomly selected from the office of one of the investigators (T.S.). The study group consisted of 29 patients with a FUPXB and the control group had 31 patients with no posterior crossbite. All patients had multislice CT scans of the TMJ taken as part of the orthodontic records. Transverse widths were measured at the skeletal base and the dentoalveolar base. Molar inclinations, condylar angulations, condylar anterior joint space, superior joint space, and posterior joint space were measured. Independent sample t-tests were used to compare different measurements between groups and paired sample t-tests were used to compare differences within the same patient. Reliability of measurements were determined using pairwise correlation. For dentoalveolar measurements of transverse width, the maxillomandibular difference for the study group was -8.2 mm and for the control group was -4.0 mm. No significant differences were found between the molar inclinations, condylar width, angulation, or any joint space measurements between the two groups. A total of 61.3% of the subjects in the control group and 72.4% in the study group had a radiographic sign of joint disease. The lack of condylar positional differences between the control and crossbite groups suggests that TMJ signs and symptoms in the study group may be related to remodeling in the TMJ instead.

A CBCT evaluation of root position in bone, long axis inclination and relationship to the WALA Ridge

Correct tooth position in all planes of space while respecting the boundaries of the underlying bone is important for stability of teeth after orthodontic treatment as well as the health of the supporting periodontium.1,2 The aim of this study was to determine: 1) if mandibular posterior teeth are more centered over basal bone when they are more upright or close to WALA Ridge norms proposed by Andrews3; 2) if mandibular posterior teeth are more centered in alveolar bone when they are more upright or close to the WALA Ridge norms; 3) if the estimated center of resistance mandibular posterior teeth is most often centered in alveolar bone; and 4) if the WALA Ridge is located at or near the estimated center of resistance of mandibular posterior teeth. A sample of 34 pre-treatment CBCT scans and mandibular casts of patients ages 12–18 were included in the study. CBCT scans were digitized and analyzed using the Carestream 3D Imaging Software Version 3.5.7. Casts were digitally scanned using the Ortho Insight 3D scanner. The WALA Ridge horizontal measurements were made using the Six Elements™ software (MotionView, Chattanooga, TN). The WALA Ridge vertical measurements were obtained from the casts using a digital caliper. Coronal CBCT images were used to measure tooth positions of pre-treatment mandibular posterior teeth relative to surrounding bone. Centeredness of teeth within the bone was quantified and compared to their inclination and to the WALA Ridge location: D1, D2, D3 and D4. Data were analyzed using the JMP version 10 SAS Software. Descriptive statistics were used to calculate the mean, standard deviation, minimum, and maximum values for the distance between WALA Ridge vertical and CR, D2, D3 and D4 for each of the posterior teeth. Single linear regression analysis was performed to evaluate the relationship between both the long axis inclination and WALA Ridge variables compared to the D1, D2, D3, variables. No statistical significance was found for centeredness of mandibular posterior teeth over basal bone when they were more upright or approached WALA Ridge norms. No statistical significance was found for centeredness of mandibular posterior teeth in alveolar bone when they were more upright or approached the WALA Ridge norms. Significant differences were found for the mandibular posterior teeth center of resistance being centered in the alveolar bone regardless of the long axis inclination or WALA Ridge norms (p-value <0.05). Significant differences were also found for the Wala Ridge being located at or near the center of resistance of mandibular posterior teeth (p-value <0.05). 1) More upright mandibular posterior teeth based on long axis inclination or mandibular posterior teeth more closely related to the WALA Ridge landmark are not more centered over basal bone. 2) More upright mandibular posterior teeth based on long axis inclination or teeth more closely related to the WALA Ridge landmark are not more centered in alveolar bone. 3) The center of resistance of all mandibular posterior teeth can most often be found in the center of the alveolar bone regardless of inclination. 4) The WALA Ridge is located at or near the center of resistance for all mandibular posterior teeth. 5) The WALA Ridge may be a useful landmark for customizing mandibular arch form if teeth are tipped to an upright position.

Morphology of mandibular lingual concavities

The literature review on assessment of lingual concavities in posterior mandibula with CBCT to prevent complications such as perforations during dental implant placement. The electronic search of full-text articles on lingual concavity studies with CBCT was performed. The data on the prevalence, depth and angle of concavities was analyzed. The analysis included 5 articles from 2011 to 2016 years. Totally 1713 mandibular concavities were evaluated in 1232 patients. The prevalence was 46.7-68%; mean depth was from 2.4 mm to 5.4 mm; and the mean angle varied from 143 to 156.6 degrees. Though morphologic data of lingual concavities showed similar pattern it is necessary to provide CBCT evaluation prior to dental implant placement to define available bone and its morphology. It is recommended to use guided surgery if U-type is evident.

CBCT analyses of advanced cervical resorption aid in selection of treatment modalities: a retrospective analysis.

The selection of treatment for advanced (classes 3 and 4) invasive cervical resorption (ICR) based on a two-dimensional periapical radiograph is challenging. The purpose of the present study is to describe different treatment approaches for advanced invasive cervical resorption based on cone-beam computed tomography evaluation. All cases of advanced ICR based on CBCT evaluation in our endodontic department between 2011 and 2016 were included in the study. The dimension, circumferential, and coronal-cervical locations of the entry point of the resorption tissue into the tooth were evaluated. The selected treatment approach for each case was documented, and all the data were summarized and analyzed. Twenty-three cases of advanced ICR were included in the study. Approximately, 74% were diagnosed in stage 4, and 26% were diagnosed in stage 3. The narrow entry point was identified in 43% (10 cases), while in 57% (13) of cases, the entry point was wide. Circumferentially, 70% (16) were located on the proximal side. Coronal-cervically, 43% (10) were located more than 1.5mm above the crestal bone. All narrow entry point cases were treated using a minimally invasive technique, while different treatment approaches were chosen for cases with a wide entry point. The present study proposes different treatment approaches for advanced ICR based on CBCT. The CBCT evaluation of the entry point may facilitate choosing the appropriate treatment approach for advanced ICR cases. The description of different treatment approaches for advanced invasive cervical resorption based on cone-beam computed tomography evaluation enables the clinician to choose the optimal treatment approach for each advanced ICR case.

3D CBCT Evaluation of Condyle Position in Skeletal Class I &amp; Class III Growing Subjects

Introduction: Evaluation of temporo-mandibular joint (TMJ) anatomy and function is an essential part of orthodontic diagnosis and treatment planning. It has been hypothesized that dental and skeletal malocclusions alter the functional loading of TMJ which can affect joint morphology.Objective: Three dimensional (3D) evaluation of condylar position using CBCT in skeletal Class I and Class III growing subjects.Materials &amp; Method: CBCT images of ten growing skeletal Class I &amp; ten Class III patients in the age range of 7-14 years were analyzed. 3D condylar position were evaluated representing antero-posterior, vertical, laterolateral position of condyle, axial condylar angle and coronal condylar angles which were measured in axial, coronal and sagittal sections using Dolphin Imaging software. Antero-posterior and vertical difference of right and left condyle were measured in axial and coronal sections respectively.Result: Paired t-Test revealed no significant difference between right and left sides of condyle in skeletal Class I as well as Class III subjects. Independent t-test and Mann-Whitney U test showed no significant difference between position of condyle in ClassI and Class III subjects.Conclusion: 3D CBCT analysis shows no significant difference in condylar position of skeletal Class I and Class III subjects.

PR617: CBCT evaluation of submandibular fossa in a group of Turkish patients

PR617: CBCT evaluation of submandibular fossa in a group of Turkish patients

Lateral alveolar ridge augmentation procedure using subperiosteal tunneling technique: a pilot study

BackgroundIn this research article, we evaluate the use of sub-periosteal tunneling (tunnel technique) combined with alloplastic in situ hardening biphasic calcium phosphate (BCP, a compound of β-tricalcium phosphate and hydroxyapatite) bone graft for lateral augmentation of a deficient alveolar ridge.MethodsA total of 9 patients with deficient mandibular alveolar ridges were included in the present pilot study. Ten lateral ridge augmentation were carried out using the sub-periosteal tunneling technique, including a bilateral procedure in one patient. The increase in ridge width was assessed using CBCT evaluation of the ridge preoperatively and at 4 months postoperatively. Histological assessment of the quality of bone formation was also carried out with bone cores obtained at the implant placement re-entry in one patient.ResultsThe mean bucco-lingual ridge width increased in average from 4.17 ± 0.99 mm to 8.56 ± 1.93 mm after lateral bone augmentation with easy-graft CRYSTAL using the tunneling technique. The gain in ridge width was statistically highly significant (p = 0.0019). Histomorphometric assessment of two bone cores obtained at the time of implant placement from one patient revealed 27.6% new bone and an overall mineralized fraction of 72.3% in the grafted area 4 months after the bone grafting was carried out.ConclusionsWithin the limits of this pilot study, it can be concluded that sub-periosteal tunneling technique using in situ hardening biphasic calcium phosphate is a valuable option for lateral ridge augmentation to allow implant placement in deficient alveolar ridges. Further prospective randomized clinical trials will be necessary to assess its performance in comparison to conventional ridge augmentation procedures.

CBCT Evaluation of the Prevalence of Impacted Maxillary Canines in a Saudi Arabian Population: A Preliminary Study

Objective: To determine the prevalence of impacted canines in a Saudi Arabian population using CBCT.Material and methods: A total of 439 CBCT scans of 241 male and 198 female subjects were analyzed in this study by two qualified observers to know the presence or absence of impacted canines and their distribution in terms of gender, jaw and side. All the obtained data were tabulated statistically analyzed using SPSS 21.0 (Chicago, USA).Results: Impacted canines were noted in 13 of 439 subjects with a prevalence of 3.03%, among which 7 (2.96%) were seen in males and 6 (3.12%) were seen in females. Out of these 13 impacted canines, 9 were observed in maxillary jaw, 3 in the right quadrant and 6 in the left quadrant. Four impacted canines were noted in mandibular jaw, 2 in right side and 2 in the left side.Conclusion: The results from the present study indicate that the prevalence of impacted canines is comparable with other studies. Most of the impacted canines were located in the maxillary jaw and in females.International Journal of Human and Health Sciences Vol. 02 No. 01 Jan’18. Page : 31-34

A CBCT evaluation of molar uprighting by conventional versus microimplant-assisted methods: an in-vivo study.

ABSTRACTObjective: The aim of this prospective study was to compare the three-dimensional effects of the conventional helical uprighting spring (CA) and the mini-implant assisted helical uprighting spring (MIA), using CBCT scans. Methods: Twenty patients with mesially tipped second mandibular molars were divided into two groups: CA group, in which 10 patients were treated using a conventional helical uprighting spring with conventional anchorage; and MIA group, in which 10 patients were treated using a mini-implant supported uprighting spring. Molar uprighting was observed in both groups for a period of four months. Two standardized 11×5-cm CBCT sections of the mandible were taken, being one prior to uprighting and one at the end of the four month follow-up. Statistical analyses at the beginning of treatment and after a 4 month follow-up were performed, with a significance level of p< 0.05.Results: The mean amount of change in mesiodistal angulation in the MIA group was 8.53 ± 2.13o (p< 0.001) and in the CA group was 9.8 ± 0.5o (p< 0 .001). Statistically significant differences were found between the two groups with regard to buccolingual inclination of canine, first and second premolars (p< 0.05), second molar (p< 0.001) and extrusion of second molar (p< 0.05). Conclusions: The mean amount of change in the mesial angulation of the second molar in the CA as well as the MIA groups was similar. MIA, which used mini-implant as a source of anchorage, was more effective in preventing movement of the anchorage teeth as well as preventing extrusion of the second molar in the vertical plane, when compared to the CA group, which used dental units as a source of anchorage.