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Non-compliant upper molar distalization, pros and cons of different mechanics using palatal mini-implants.
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Benedict Wilmes
Course details
Lecturers
Details
1h 51min
English
Lesson program
A treatment objective of upper molar distalisation may often be indicated for the correction of a dentoalveolar Class II malocclusion with an associated increased overjet and/or anterior crowding. Due to aesthetic concerns and the duration of treatment, molar distalisation using headgear is unacceptable for many patients. This has resulted in a preference for purely intraoral distalisation appliances which require minimal patient cooperation. Unfortunately, most conventional devices for non-compliance maxillary molar distalisation produce unwanted side effects, such as anchorage loss. If the anchorage unit includes teeth, mesial migration and/or protrusion of the anterior dentition need to be considered as major disadvantages. To minimise or eliminate anchorage loss related to the anterior teeth, skeletal anchorage has been integrated into distalisation appliances. The anterior palate has proved to be an ideal site for miniscrew placement for the distalisation of upper teeth. The good bone quality, the attached mucosa, and the minimal risk of injury to nearby teeth have been suggested as major advantages of miniscrew placement in this region. Furthermore, the mini-implants are unlikely to be in the path of tooth movement. Skeletal anchorage mechanics can be divided in direct and indirect appliances. If the maxillary molars are to be distalised, direct anchorage is advantageous, since a major disadvantage of devices employing indirect anchorage is the need for a two-phase clinical procedure: (a) distalisation of the molars, and (b) stabilisation of the molars while retraction of the anterior dental segment occurs. To benefit from the advantages of direct anchorage mechanics and use the anterior palate as the most suitable mini-implant insertion site, the Beneslider and the Pendulum B mechanics may be employed.
Lecturers 1
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Professor and Deputy Director of the Department of Orthodontics at Heinrich Heine University Düsseldorf, Germany (Professor since 2013). Specialist in orthodontics and dentofacial orthopedics with focus on non-compliant and invisible treatment strategies including temporary anchorage devices (TADs), lingual orthodontics, and clear aligner therapy. Maintains private orthodontic practice in Düsseldorf alongside academic position.
Over 20 years of clinical and academic experience treating complex orthodontic cases using skeletal anchorage systems and digital workflows. Pioneer in developing innovative TAD applications including palatal TADs with exchangeable abutments for transverse expansion, orthopedic protraction, and molar distalization. Research focuses on digital orthodontics, CAD/CAM technologies for customized appliances, biomechanics of skeletal anchorage, and treatment efficiency in adult orthodontics. Expert in combining TADs with aligners for predictable complex tooth movements.
Active Member of the Edward H. Angle Society of Orthodontists (Eastern Component). Recipient of First Prize from the German Orthodontic Society (DGKFO, 2007), First Prize from the European Orthodontic Society (EOS, 2009), and First Prize from the German Society for Lingual Orthodontics (2018). Author of over 200 peer-reviewed publications and textbook chapters on TADs, lingual orthodontics, and digital orthodontics. Reviewer for numerous international orthodontic journals including American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, European Journal of Orthodontics, and others. International lecturer having delivered over 300 lectures and courses in 70 different countries worldwide on skeletal anchorage, digital treatment planning, and contemporary orthodontic biomechanics.
DMD from Heinrich Heine University Düsseldorf, Germany. Postgraduate degree (Dr. med. dent.) in Orthodontics and Dentofacial Orthopedics from Heinrich Heine University Düsseldorf. Professor appointment at University of Düsseldorf (2013).
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