Pendulum Appliance Research Articles

The Application of Pendulum as a Space Regainer in Orthodontic Treatment

Background: The process of distalization in orthodontic treatment is often very difficult. The most common method is the use of cervical headgear. However, due to poor patient compliance, it leads to poor treatment outcomes. Treatment alternatives that require minimal compliance include Jones jig, magnets, and pendulum. Objective: This study aimed to perform distalization of a maxillary molars on a bilateral Class II molar relationship patient with a crowded maxillary arch. Case Report: A 10-year-old female with a Class II molar relationship, bilateral posterior crossbite, and nonerupted upper canines was treated with a rapid palatal expander (RPE), pendulum appliance, and fixed appliance. The crowding in the maxillary arch and spacing in the mandibular arch were eliminated, and transverse discrepancies were corrected. Conclusion: Pendulum appliance is very effective in creating spaces for the eruption of canines and ectopic premolars. Pendulum appliances have been introduced for a long time and have proven successful for molar distalization and space regainer and require minimal patient cooperation. Like other distalization appliances, distal tipping of the molars and mesial movement of the premolars could be observed.

CAD/CAM Designed Framework for Bone-Anchored Pendulum Appliance

This article describes the use of a computer-aided design and manufacturing (CAD/CAM) 3D metal printed adjunctive orthodontic appliance that can be used with palatal miniscrews for molar distalization. CAD/CAM technology was used to fabricate a customized framework for bone-anchored pendulum appliance effectively based on the patient’s palatal contour, location, and the number of implants to be placed.

Clinical Evaluation of Bone-Anchored Intraoral Bodily Molar Distalizer

Introduction: Correction of Class II has become a routine with the introduction of mini-implants. Objective: The objective of the study was to evaluate the clinical efficiency of bone-anchored intraoral bodily molar distalizer (BAIBMD) as compared to bone-anchored pendulum appliance (BAPA). Materials and Methods: This split-mouth study included 11 subjects (6 boys and 5 girls) who required molar distalization. BAPA constructed on one side and BAIBMD on the other side. Both the appliances were anchored to the bone, using a single 2 × 8 mm titanium mini-screw placed in the anterior para-median region of the mid-palatal suture with its head embedded into the Nance button during construction. The force delivery mechanism on both the sides consisted of 200 g-force application, using an activated 0.032˝ titanium molybdenum alloy (TMA)[A]:Author: Please provide expansion for “TMA.” springs fabricated with respective designs and inserted into the lingual sheaths of the first molar bands. The rate, duration, and nature of tooth movement for both the sides were compared. Descriptive statistics for various parameters were analyzed using Wilcoxon signed-rank test. Results: Clinically successful distalization was achieved on both sides. No statistical difference was found in the rate of distalization. Differences in the treatment duration between the two groups were statistically significant, with less duration taken for distalization with BAPA. Statistically significant molar tipping was observed in BAPA. Conclusion: While both the appliances provided a similar rate of distalization, BAIBMD took more duration than BAPA but produced a predominantly translatory type of distal tooth movement.

Occlusal Plane Changes After Molar Distalization With a Pendulum Appliance in Growing Patients with Class II Malocclusion: A Retrospective Cephalometric Study.

This study aimed to evaluate the skeletal and dental changes after distalization with a pendulum appliance in growing patients with Class II malocclusion, focusing on the occlusal plane (OP). The sample included 24 patients with Class II malocclusion (10 boys, 14 girls); their mean age was 12.1 years. All patients underwent molar distalization and had 2 serial cephalograms traced at baseline (T1) and after distalization (T2). Angular and linear dental changes were calculated by taking the sella-nasion (SN), palatal plane (PP), and pterygoid vertical as reference. OP inclination was compared with SN, PP, and mandibular plane. The collected data were computed for all the tested variables, and one-way paired t-test was used to assess the significance of the differences between the time points. α was set at 0.05. Multiple linear regressions were used to predict the OP changes. The mean total treatment time was 8±2 months to obtain a super Class I molar relationship. In T1-T2 interval, statistically significant incisor buccal tipping of 5°±3.6° (p<0.05), first molar distal tipping of 8.9°±8.3° (p<0.001), and second molar tipping of 8.2°±8.1° (p<0.001) were observed. The maxillary first and second molars moved significantly backward by 2.8±3.2 mm (p<0.05) and 3.7±2.7 mm (p<0.001), respectively. Only the premolars showed a statistically significant anchorage loss of 2.7±3.3 mm (p<0.05); overjet increased significantly at 1.3±1.2 mm (p<0.05). Regarding the OP, none of the tested variables showed any statistically significant changes between T1-T2. The pendulum appliance showed efficacy in distalizing the maxillary first and second molars at the expense of anterior anchorage loss. The OP did not show statistically significant changes after molar distalization.

Molar distalization – A review

Esthetics plays a major role from orthodontic treatment to results. Gaining space in dental arch is the most important step in the treatment planning which can be achieved by different methods one of which is molar distalisation. To distalise molars in upper arch using non-extraction treatment, various appliances have been invented. The first attempt for this technique was the use of headgear appliance, but this needed patient compliance and was esthetically unpleasing. Thus, various intra-oral devices were introduced for molar distalisation. Keywords: Disitilisation, Pendulum appliance, Anchorage.

Stability of class II treatment with Pendulum and Jones jig followed by fixed appliances.

The present study aimed to evaluate and compare the long-term stability of Class II correction with the Pendulum or Jones jig followed by fixed appliances. Group 1 comprised 20 Class II malocclusion patients with a mean initial age of 13.97years (SD=1.57), treated with Pendulum and fixed appliances for a mean period of 4.72years (SD=0.98), and mean long-term post-treatment evaluation of 4.72years (SD=0.97). Group 2 consisted of 18 Class II patients with a mean initial age of 13.19years (SD=1.26), treated with Jones jig and fixed appliances for a mean period of 3.96years (SD=0.92). Mean long-term post-treatment time was 5.50years (SD=1.57). Lateral cephalograms were evaluated at three stages: initial (T1), final (T2) and long-term post-treatment (T3). Intragroup comparisons were performed with repeated measures ANOVA and Tukey's test and intergroup comparisons with independent t test. Many treatment changes were observed in both groups. From the long-term post-treatment periods, there was stability for most of the variables. Maxillary second molars and mandibular first molars extruded in the Jones jig group and slightly intruded in the Pendulum appliance group. The nasolabial angle decreased in the Pendulum group and increased in the Jones jig group. The correction of a Class II malocclusion was shown to be stable with similar long-term post-treatment results with Pendulum or Jones jig followed by fixed orthodontic appliances.

Transverse stability of Class II malocclusion correction with the pendulum appliance

This study aimed to evaluate the stability of transverse changes after Class II malocclusion correction with the pendulum fixed distalizer, followed by preadjusted edgewise fixed orthodontic appliances. This longitudinal study was conducted in the maxillary dental casts of 20 Class II malocclusion subjects (mean age, 12.5years; 14 females and 6 males). Eighty 3-dimensional maxillary dental casts were analyzed; 20 at the beginning of treatment, 20 after distalization, 20 after edgewise appliance debonding, and 20 at 5years posttreatment. Maxillary transverse distances between canines, first premolars, second premolars, first molars, and secondmolars were analyzed using GeomagicStudio 5 (3D Systems, Rock Hill, SC). There were no significant changes in intercanine distance during and after treatment. There were significant interfirst and intersecond premolar distance increases during treatment. There were significant interfirst and intersecond molar distance increases during the distalization phase. However, there were significant decreases in these distances at the end of treatment. There were no significant long-term posttreatment changes. The intercanine distance remains stable during and after treatment. The interfirst and intersecond premolar distances significantly increase during treatment and remain stable after treatment. The interfirst and intersecond molar distances increase during the distalization phase, decrease at the end of treatment, and remain stable after treatment.

Maxillary molars distalization: a review

Class II malocclusion is ranked as the most prevalent type of glitches that require orthodontic treatment. It can be managed via several lines of treatment the choice between which must be dependent on each case requirements. Maxillary molars distalization is one of the most popular non extraction alternatives for class II treatment. There are many distalization appliances listed in the literature which can be categorized to either compliance or non-compliance types. Compliance distalization appliances include head gear, Cetlin appliance, Wilson Biometric Distalizing Arch and Carrieredistalizer. Lack of patient cooperation comprises a major problem of these appliances and always leads to lengthy treatment in addition to less than ideal results. Non-compliance distalization appliances for class II treatment include NiTi coil springs, Pendulum appliance, Distal jet, Keles slider and Fast Back appliance. Most of these appliances gain anchorage from dental structures or Nance palatal holding arch. This always leads to adverse effects as consequences of anchorage loss represented in mesial movement of premolars and anterior teeth, increased overjet and palatal tissue irritation by the non-hygienic Nance acrylic button. Distalization appliances that involve a stable skeletally anchored modules have recently gained large popularity to avoid anchorage loss. It implies insertion of temporary anchorage devices (TADs) in different location of skeletal structures to receive and resist the reactive forces of distalization. Implant, miniplates and miniscrews are the main TADs used for orthodontic purposes. However, implants and miniplates are not widely used as they are expensive and require special surgical intervention. Miniscerws are the most common type of TADs due to their easy insertion, reasonable cost and many head designs that accommodate different orthodontic uses.

Maxillary premolars extraction or molar distalization with or without TADs: cephalometric evaluation of soft tissue changes in Class II treatment

Introduction: Problem solving in Class II malocclusion treatment performed with premolars extractions or distalizing techniques in relation to the profile modification.&#x0D; Aim: To cephalometrically compare soft tissue changes produced either by maxillary premolar extraction, tooth-borne Pendulum appliance or bone-borne MGBM appliance.&#x0D; Materials and Methods: Both pre- (T1) and post-treatment (T2) lateral cephalograms of 89 skeletal Class II patients (36 M, 53 F), treated during pubertal growth spurt, were retrospectively selected. Three groups were formed based on the therapy performed: 30 patients had been treated with maxillary first premolars extraction (U4), 31 patients with a conventional tooth-borne distalizing with Pendulum appliance (PA), and 28 patients with a skeletally anchored distalizing appliance (MGBM). Soft tissue was analyzed comparing upper (UL) and lower (LL) lip’s points with regard to True Vertical Line (TVL) and Esthetic plane (E-plane). Skeletal and dental values have been recorded in order to cephalometrically compare ΔT2-T1 changes among groups and to correlate dental and skeletal changes to profile modifications. One-way ANOVA was employed to compare groups at T1. Paired sample t-tests were employed to assess significant intra- and intergroup differences between T2 and T1. Significance level was set at 0.05&#x0D; Results: UL and LL showed a slight but not significant retrusion relative to TVL in all three groups. UL and LL distances to E-plane were not statistically significant among U4, PA, and MGBM groups. Independently of the treatment, UL was tangent to TVL in all groups. No statistically significant differences have been shown in skeletal records. Significant differences were recorded in Overjet among U4 than PA and MGBM groups.&#x0D; Conclusions: Class II malocclusion treatment with maxillary first premolar extraction, conventional or skeletal distalization did not significantly affect the profile producing similar changes in the soft tissue.

Non-Extraction Management of Class II Malocclusion by Molar Distalization: A Report of Two Cases

A case series of two females, who reported to the Department with Angle's Class II molar relationship and bucally placed upper canines, lip strain and a straight profile with average growth pattern. Pendulum appliance was used to distalize the upper molars and Class I molar relationship was achieved in less than 4 months and 4–5 mm of space was created. The space gained was used in the correction of the maxillary anterior crowding, correcting the lip strain in the process.

Evaluation of the effects of the hybrid Pendulum in comparison with the conventional Pendulum appliance.

To evaluate the anchorage control and distalization of maxillary molars with the hybrid Pendulum appliance and to compare the results with a conventional Pendulum appliance. This study was carried out on the pre-(T0) and post-(T1) treatment lateral cephalograms and dental casts of 43 patients with Angle Class II molar relationships who were treated with conventional or hybrid Pendulum appliances. The hybrid Pendulum (HP) group consisted of 22 patients (14 females; eight males; mean age 14.3 ± 2.43 years) and treatment results were compared with a conventional Pendulum appliance (CP) group, which consisted of 21 patients (15 females; six males; mean age 14.6 ± 3.39 years). Intragroup comparisons were made with Wilcoxon test and intergroup comparisons were made with Mann-Whitney U-test (P < .05). The mean distalization duration was 0.70 ± 0.25 years in the HP group and 0.83 ± 0.4 years in the CP group. Maxillary first molars showed significant distal movement and tipping of 4.25 mm and 9.09° in the HP group, and 3.21 mm and 9.86° in the CP group. Loss of anchorage at the first premolars was significantly smaller in the HP appliance group compared to CP group. The second premolars distalized spontaneously in the HP group while they mesialized significantly in the CP group. Proclination and protrusion of maxillary incisors were greater with the CP appliance compared to the HP appliance. Maxillary molar distalization was achieved with both appliances. Mesialization of the anchorage unit was controlled successfully with the hybrid Pendulum; however, the conventional Pendulum appliance caused anchorage loss.

Three-dimensional comparison of the skeletal and dentoalveolar effects of the Herbst and Pendulum appliances followed by fixed appliances: A CBCT study.

To compare three-dimensional (3D) skeletal and dentoalveolar effects of the Herbst and Pendulum appliances followed by fixed orthodontic treatment in growing patients. A sample of 35 adolescents with cone-beam computed tomography scans obtained prior to Herbst and Pendulum treatment (T1) and immediately after fixed appliance treatment (T2). Patients with Class II malocclusion was assessed retrospectively and divided into two treatment groups: Herbst group (n=17, age: 12.0±1.6years) and Pendulum group (n=18, age: 12.1±1.5years), with a mean treatment duration of 2.8±0.8years and 2.5±0.7years, respectively. Reconstructions of the maxillomandibular and dentoalveolar regions and data in 3D were obtained relative to cranial base, maxillary and mandibular regional superimpositions. Treatment outcomes (T2-T1) were compared between both groups using t tests for independent samples (P<.05). Significant increase in mandibular length was observed in the Herbst group (7.3±3.5mm) relative to the Pendulum group (4.6±4.5mm). Inferior and anterior displacements of Pogonion were 2.2mm and 1.6mm greater in the Herbst group, respectively. The mesial displacement of the lower first molars was significantly greater in the Herbst group (1.9mm). The upper first molars had contrasting results in sagittal displacement, with 0.6±1.7mm of distal displacement with the Pendulum and 1.4±2.1mm of mesial displacement with the Herbst. Lower incisor projection and proclination were similar between groups. The Herbst and Pendulum appliances followed by comprehensive orthodontic treatment effectively corrected Class II malocclusion in growing patients, but with differing skeletal and dentoalveolar effects.

Tissue Friendly Pendulum: Soft Liner to prevent Tissue Irritation

Palatal mucosal irritation is commonly encountered with the Pendulum appliance. The efficiency of soft liners in reducing tissue irritation has been well documented in the field of prosthodontics. The following article describes an innovative technique where soft liner can be used to reduce palatal mucosal irritation caused by pendulum appliance.

Class II treatment by palatal miniscrew-system appliance: A case report

This case shows that using a rapid palatal expander (RPE) and then a pendulum appliance anchored to palatal miniscrews is an option for improving treatment management in a noncompliant patient requiring maxillary expansion and molar distalization in the late mixed dentition. First, an RPE was used to expand the maxillary arch. Then, a modified pendulum appliance was used to distalize the maxillary first permanent molars. Optimal positioning of two palatal miniscrews enabled both appliances to be supported by skeletal anchorage. Treatment was finished using multibracket fixed appliances, and after 2 years, skeletal Class I as well as dental Class I canine and molar relationships were achieved.

Cephalometric Changes Produced by the Distal Jet and Pendulum Appliances in Class II Malocclusion Treatment

This study aimed to compare the dentoskeletal and soft tissue changes promoted by the Distal Jet and Pendulum, followed by fixed appliances, in class II malocclusion treatment, evaluated in relation to an untreated control group. Group 1 comprised 20 patients (15 female; 5 male) with class II malocclusion, at an initial mean age of 12.77 years. These patients were treated with the Distal Jet followed by fixed appliances for a mean period of 4.15 years. Group 2 consisted of 15 patients (10 female; 5 male) with class II malocclusion, at an initial mean age of 13.42 years, treated with the Pendulum followed by fixed appliances for a mean period of 4.41 years. Group 3 comprised 16 subjects (8 female; 8 male), with class II malocclusion, not submitted to any orthodontic treatment. This group had an initial mean age of 12.25 years. The mean observation period was 3.73 years. Comparison of the three groups was performed by one-way ANOVA followed by Tukey tests. The Distal Jet appliance showed more palatal tipping of the maxillary incisors than the Pendulum. The treated groups showed more overjet reduction and improvement of molar relationship than the control group. It was concluded that the effects of these two appliances in Class II malocclusion correction are very similar. Both Distal Jet and Pendulum appliances corrected the class II malocclusion with similar cephalometric treatment changes.

Evaluation of Dentoalveolar and Dentofacial Effects of a Mini-Screw-Anchored Pendulum Appliance in Maxillary Molar Distalization.

The aim of this study was to evaluate the dentoalveolar and dentofacial effects of a mini-screw-anchored pendulum appliance in maxillary molar distalization. Twenty patients with the Angle Class II molar relationship (mean age 14.05±2.4 years) were treated with a mini-screw-anchored pendulum appliance for molar distalization. A mini-screw 1.9 mm in diameter and 9 mm in length was used to support the pendulum appliance. The springs of the pendulum appliance were activated at 90° and exerted 250-300 gr force per side. Lateral cephalometric radiographs and dental cast models were obtained from all the patients before and after maxillary molar distalization. A 0.6° increase in the SNA and SNB angles, and a 0.3° decrease in the SN/GoGn angle were found to be statistically significant. In the maxillary first molars, 4.2-mm significant distalization, 0.6-mm significant intrusion, and 8.9° significant distal tipping were observed. The spontaneous distal drift of the maxillary second premolars was found to be statistically significant. In the maxillary first premolar and incisor positions, significant mesialization was observed; however, the changes in the angles of these teeth were found to be insignificant. A mini-screw-anchored pendulum appliance is an effective method for maxillary molar distalization that controls the undesired anchorage loss observed in conventional methods.

Comparison Between Bone Supported -Pendulum Appliance and Lever-arm Mini-implant System in Maxillary Molar Distali zation in Class II Malocclusion

Upper molar distalization with noncompliance therapies has become more popular in treatmentof Class II malocclusions.Purpose: This study was conducted to evaluate and compare the dentofacial changes afterdistalization of maxillary first molars using bone anchorage pendulum and Lever-arm mini-implantsystem in the treatment of dental Class II cases non-extraction cases.Subjects and Methods: The sample of this study was consisted of 30 patients of both sexes(16- 22 years old) divided into two groups. The first group consisted of 15 patients, their molar weredistalized with BAPA. The second group consisted of 15 patients, their molar were distalized withLAMS. The evaluation of the study was performed by detecting the changes on dental casts andlateral cephalograms.Results: All maxillary molars were distally moved into a super class I relationship successfullyin both groups (7.2 months in BAPA group and 10.5 months in LAMS group) and there was ahighly significant changes in the distal tipping of the maxillary first molar between the two groups,BAPA (22.8°) while the amount of distal tipping of the maxillary first molar in LAMS group was(10.29°).Conclusion: Both LAMS and BAPA appliances were effective, less invasive and compliancefree alternative for intraoral upper molar distalization without anchorage loss. Lever-arm and miniimplantsystem was effective for achieving absolute anchorage during the distal movement of uppermolars.

Analysis of effects from usage of skeletal anchorage-assisted Pendulum appliance on vertical component of craniofacial structure

Analysis of effects from usage of skeletal anchorage-assisted Pendulum appliance on vertical component of craniofacial structure

Comparative Distalization Effects Of Conventional Pendulum Appliance And Bone Anchored Pendulum Appliance

Abstract Introduction: The introduction of intraosseous screws as temporary orthodontic anchorage devices has proved successful in achieving sufficient molar distalization without major anchorage loss in Class II malocclusions. Bone-anchored pendulum appliance is used to obtain an effective and compliance-free molar distalization without anchorage loss. Aims And Objectives: This prospective study was designed to evaluate and compare the skeletal and dentoalveolar effects produced by 2 types of pendulum appliance with different anchorage modalities - the Bone anchored pendulum appliance (BAPA) and Conventional pendulum appliance (CPA) in subjects with Angle's ClassII malocclusion. Materials and Methods: BAPA group consisted of 5 patients with mean age, 16.4±1.5 years. The CPA group consisted of 5 patients with mean age, 16.6±1.1 years. Lateral cephalograms &amp; dental casts were obtained at pre-treatment stage &amp; after achieving Class I molar relation. Dentoalveolar, skeletal, soft tissue measurements and dental cast measurement were recorded &amp; compared between the groups. Results and Conclusions: Successful distalization was achieved in both groups in a mean period of 6.2 months for BAPA and 5.2 months for CPA. It was concluded that, both theBAPA and CPA were effective for the distalization of maxillary molars. Though the distal molar movements obtained were similar between the BAPA and the CPA groups, anchorage loss was observed with the CPA in the form of premolar mesialization &amp; incisor proclination, whereas absence of anchorage loss, significant spontaneous distal premolar movement, and distal incisor movement was observed with the BAPA, making it a viable choice compared to the CPA.

Pendulum appliance and K-loop combination for molar distalization: A case report

Pendulum appliance and K-loop combination for molar distalization: A case report