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Maxillary molar distalization has been used in orthodontics for over 100 years. This technique has been used to gain space in the maxillary arch for relief of crowding, correction of a Class II molar relationship and reduction of an increased overjet. A plethora of appliances have been developed over the years with each having advantages and disadvantages. This article details the indications and contra-indications for maxillary molar distalization and details the various appliances that are available to clinicians, presenting the available evidence supporting the use of these various appliances.
Clinical Relevance: Clinicians should be familiar with the clinical indications for maxillary molar distalization, the potential unwanted effects and how these can be minimized. Clinicians should also appreciate how molar distalization can be incorporated with other aspects of orthodontic care.
Article
Angle used traction headgear appliances to retract the maxillary molars in cases with Class II division 1 malocclusion.1 Molar distalization is the term that is now used for lengthening the dental arch by posterior movement of the buccal segment teeth in order to provide space in the maxillary arch.2 Distal movement of the maxillary molars is mainly used to correct a Class II molar relationship,3,4 to reduce a mild to moderately increased overjet5 or for treatment of midline deviation problems.6 As an interceptive measure, maxillary molar distalization can also provide space for spontaneous eruption of ectopic canines. This has been shown to have a success rate of 80% compared to 50% in a control group.7 In addition, molar distalization can be used to regain lost space caused by mesial migration of molars in premolar crowding cases and to upright maxillary first permanent molars when they are impacted against maxillary deciduous second molars.8,9
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