Skeletal and dentoalveolar changes after total maxillary arch distalization using the casted palatal plate vs. buccal miniscrews: A Randomized clinical trial.

Objectives: To evaluate the skeletal, dento-alveolar and soft tissue changes after skeletally anchored total maxillary arch distalization using the casted palatal plate in comparison with buccal miniscrews. Materials: & Methods: 40 adult patients (33 females and 7 males, average age 20 ± 3.1 years) with distal molar and canine relationships were treated with total maxillary arch distalization. Patients were divided according to the direct skeletal anchorage method into two equal groups; in the first group; 20 patients the casted palatal plate was used, while in the second group; 20 patients buccal miniscrews were inserted. A total of 35 variables were measured on pre- and post-distalization lateral cephalograms. Paired t-tests were used to evaluate the differences between pre- and post-distalization in each group, and independent t-tests were used to compare treatment changes between the two groups. Results: : A significant distalization combined with intrusion and distal tipping of the maxillary first molar were observed in the plate group (4.33 mm, 1.85 mm and 3.10°, respectively). While the miniscrews group showed less amount of distalization with non-significant intrusion and distal tipping (1.88 mm, 0.8 mm and 2°, respectively). The plate group showed more decrease of SNA, ANB, B-angles and Wits-distance. There were no significant differences between the two groups regarding sagittal, vertical and angular changes of the maxillary incisors as well as soft tissue changes. Conclusions: : Both of the casted palatal plate and buccal miniscrews might be viable as anchorage devices for total maxillary arch distalization during the treatment of Class II malocclusion patients. However, the casted plate may be considered more effective in either retraction or vertical control. Clinical relevance: Skeletally anchored maxillary total arch distalization could be an effective treatment procedure for Class II malocclusion.