Zygoma-gear appliance for intraoral upper molar distalization

Metin Nur; Mehmet Bayram; Alper Pampu

doi:10.4041/kjod.2010.40.3.195

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Zygoma-gear appliance for intraoral upper molar distalization

Original Article

Korean J Orthod 2010;40(3):195-206.

Published online: 19 January 2010

DOI: https://doi.org/10.4041/kjod.2010.40.3.195

Zygoma-gear appliance for intraoral upper molar distalization

Metin Nur, DDS, PhD^a, Mehmet Bayram, DDS, PhD^a, Alper Pampu, DDS, PhD^b

^aAssistant Professor, Karadeniz Technical University, Department of Orthodontics, Trabzon, Turkey

^bAssistant Professor, Karadeniz Technical University, Department of Oral Surgery, Trabzon, Turkey

Corresponding author: Mehmet Bayram. Karadeniz Technical University, Department of Orthodontics, Trabzon, Black Sea 61080, Turkey. ＋90 462 3774724; e-mail, dtmehmetbayram@yahoo.com.

Received 26 January 2010 Revised 6 March 2010 Accepted 9 March 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this report is to present an intraoral upper molar distalization system supported with zygomatic anchorage plates (Zygoma-gear Appliance, ZGA). This system was used for a 16-year-old female patient with a Class II molar relationship requiring molar distalization. The system consisted of bilateral zygomatic anchorage plates, an inner-bow and heavy intraoral elastics. Distalization of the upper molars was achieved in 3 months and the treatment results were evaluated from lateral cephalometric radiographs. According to the results of the cephalometric analysis, the maxillary first molars showed a distalization of 4 mm, associated with a distal axial inclination of 4.5°. The results of this study show that an effective upper molar distalization without anchorage loss can be achieved in a short time using the ZGA. We suggest that this new system may be used in cases requiring molar distalization in place of extraoral appliances.

Keywords: Distalization, Zygomatic anchorage plate, Class II, Anchorage

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Fig 1.

Schematic illustration of components (A) and the effective distalizing force vector of the ZGA (Zygoma-Gear Appliance) (B).

Fig 2.

The zygomatic anchor plates adapted and fixed to the zygomatic buttress.

Fig 3.

Pretreatment facial and intraoral photographs of the case.

Fig 4.

Pretreatment diagnostic models of the case.

Fig 5.

Pretreatment radiographic records of the case.

Fig 6.

Intraoral occlusal views of the mechanics for erupting of the impacted canines (A), and of the erupted canines (B).

Fig 7.

Application of the ZGA (Zygoma-Gear Appliance) at the beginning of distalization (A), and the views of the patient immediately after the distalization (B).

Fig 8.

Lateral cephalometric radiograph of the case taken immediately after the distalization.

Fig 9.

The system for retraction of the incisors.

Fig 10.

Posttreatment facial and intraoral photographs of the case.

Fig 11.

Posttreatment dental casts of the case.

Fig 12.

Posttreatment radiographic records of the case.

Fig 13.

Intraoral photographs of the case after restoring the peg shaped upper lateral incisors.

Fig 14.

Superimpositions of pre- and post-distalization (A), and pre- and post-treatment cephalometric tracings (B).

Table 1.

Cephalometric measurements of the patient

	Pretreatment	Beforedistalization	Afterdistalization	Posttreatment
SNA(°)	82	81	81	80.5
SNB(°)	76	76	76.5	77
ANB(°)	6	5	4.5	3.5
SN-GoGn(°)	34.5	34	34.5	34
FMA(°)	22.5	23	23	22.5
ANS-PNS/GoGn(°)	23	23	22.5	22.5
S-Go(mm)	72.5	73	73	73
N-Me(mm)	115	115.5	115	115
ANS-Me(mm)	62	61.5	61	61.5
S-Go/N-Me(%)	63	63.2	63.4	63.4
Witsappraisal(mm)	5.5	2.5	2	2
U1-NA(mm)	2	2.5	4	3.5
U1-NA(°)	13	16	20	20.5
U1-ANS-PNS(°)	106.5	107.5	108	112
L1-NB(mm)	5	4	2.5	4
L1-NB(°)	23	20	17	23
IMPA(°)	92.5	90	88	93.5
U1-PtV(mm)	60.5	60	60	60
U6-PtV(mm)	33.5	33	29	30
U6/ANS-PNS(°)	92	90.5	85	90
Interincisalangle(°)	138	140	139.5	133.5
Overjet(mm)	4	4.5	4.5	2.5
Overbite(mm)	6	4.5	5	4
Lowerlip-Eline(mm)	0	0.5	0.5	1
Upperlip-Eline(mm)	1.5	4	4	4
Nasolabialangle(°)	111	114	114	112

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