Skeletal versus conventional intraoral anchorage for the treatment of class II malocclusion: dentoalveolar and skeletal effects

Prog Orthod. 2014;15(1):43. doi: 10.1186/s40510-014-0043-z. Epub 2014 Jul 30.


Background: The purpose of this retrospective study is to investigate the dentoalveolar and skeletal effects of two distalizing protocols featuring different anchorage systems used in patients with class II malocclusion: the MGBM system (skeletal anchorage) and Pendulum (intraoral anchorage).

Methods: The sample comprised 57 patients who were assigned to one of the two treatments: the MGBM group (30 patients, mean age 13.3 ± 2.3 years) or the Pendulum group (27 patients, mean age 12.8 ± 1.7 years). Three serial cephalograms were obtained at baseline (T0), after molar distalization (T1), and after fixed appliance treatment (T2). Esthetic, skeletal, and dental parameters were considered. Pancherz's superimposition method was used to assess sagittal dental changes. The initial and final measurements and treatment changes were compared by means of a paired t test or a paired Wilcoxon test. Statistical significance was tested at p < 0.05, p < 0.01, and p < 0.001.

Results: In the MGBM group, the upper molar distalization was achieved in 7 months and showed a mean value of 4.9 mm (ms-PLO); the amount of molar relationship correction was 5.9 mm. In the Pendulum group, the upper molar distalization was obtained in 9 months and showed a mean value of 2.5 mm (ms-PLO), while the molar relationship correction amounted to 4.9 mm. Anterior anchorage loss occurred in both groups, although in the MGBM group, there was less mesial movement of the premolars.

Conclusions: The MGBM system and the Pendulum appliance are both effective in the correction of class II malocclusions. The MGBM system was found to be more efficient than the Pendulum appliance, producing greater molar distalization in a shorter treatment time.

Keywords: Class II malocclusion; Molar distalization; Pendulum; Tad's.

MeSH terms

  • Adolescent
  • Bicuspid / pathology
  • Cephalometry / methods
  • Child
  • Esthetics, Dental
  • Follow-Up Studies
  • Humans
  • Malocclusion, Angle Class II / therapy*
  • Mandible / pathology
  • Maxilla / pathology
  • Molar / pathology
  • Nasal Bone / pathology
  • Orthodontic Anchorage Procedures / instrumentation*
  • Orthodontic Appliance Design*
  • Retrospective Studies
  • Sella Turcica / pathology
  • Time Factors
  • Tooth Movement Techniques / instrumentation
  • Treatment Outcome