Abstract

Distalisation in the Maxilla: when, how and why?

by Nienkemper Manuel

Depending on the origin of a distal occlusion molar distalisation can be of great benefit for the patient. But of course this is not suitable for every patient. Conventional distalization techniques, including extraoral appliances and intraoral tooth-borne or tooth-tissue-borne devices, are often associated with unwanted side effects such as anchorage loss, mesial movement of anterior teeth, extrusion of molars, and increased reliance on patient compliance. The introduction of temporary anchorage devices (TADs), particularly palatal mini-implants, has significantly expanded the biomechanical possibilities for predictable, compliance-independent molar distalization with improved anchorage control. The lecture focuses on indications and mechanics of upper molar distalisation and on optimising the insertion of the TAD`s. Where is the best spot for insertion? What is the best work-flow? What are the requierements for the design of the screw? What are the best biomechanics depending on the individual clinincal finding and how should the appliance be designed to avoid side effects and to reliably achieve the reatment goals? What problems can occur and how can they be avoided as reliably as possible?