IADR Abstract Archives
Efficacy of Mandibular Molar Distalization : a Systematic Review and Meta-Analysis
Objectives: The aim of this study was to evaluate the efficacy of mandibular molar distalization by means of a systematic review of the literature, determining the quantity and quality of the displacement achieved, the stability of the results obtained and the anatomical limits to the movement. In addition, a comparison was made between the various intra-oral devices used to achieve this procedure.
Methods: A bibliographic research was carried out on four different databases, namely "MedLine", "Google Scholar", "Cochrane library", and "EBSCOhost". A combination of MeSH keywords and lexical fields specific to the search topic was used. Following this literature search, data were extracted and the risk of bias of the studies included was assessed. The quantitative data extracted from these studies enabled a meta-analysis to be carried out with the aim of concluding on a quantitative reference value for each variable sought, and comparing the different methods and devices used to distalize the mandibular molars.
Results: A mean quantity of distalization of 3.04 mm was calculated by referring to the dental casts for the mandibular first molars. A mean quantity of distalization of 2.48 mm and 2.31 mm, 2.67 mm and 2.24 mm, 1.10 mm and 1.36 mm, 1.16 mm and 2.47 mm, was calculated for the first and second mandibular molars with reference to the VMP, VFH, CBCT coordinate system and CoGo planes respectively. A mean distalization quality of 5.86° and 6.61°, 46.3% and 26.2% was calculated for the first and second mandibular molars in angular value and tipping ratio respectively. A mean distalization stability of 0.17 mm and 0.42 mm, 0.22° and 0.84° was found for the first and second mandibular molars using the VFH plane and angular measurements respectively. A mean distalization limit of 1.53 mm, 2.70 mm and 1.81 mm was calculated with reference to the sagittal line, cuspid line and C-plane, respectively.
Conclusions: This meta-analysis demonstrated that mandibular molar distalization is effective, with a threshold value of 2.70 ± 0.52 mm accepted as the limit for translational movement. However, it is recommanded that a CBCT scan calculating the individualised threshold value be performed each time the mandibular distalization protocol is indicated.
Methods: A bibliographic research was carried out on four different databases, namely "MedLine", "Google Scholar", "Cochrane library", and "EBSCOhost". A combination of MeSH keywords and lexical fields specific to the search topic was used. Following this literature search, data were extracted and the risk of bias of the studies included was assessed. The quantitative data extracted from these studies enabled a meta-analysis to be carried out with the aim of concluding on a quantitative reference value for each variable sought, and comparing the different methods and devices used to distalize the mandibular molars.
Results: A mean quantity of distalization of 3.04 mm was calculated by referring to the dental casts for the mandibular first molars. A mean quantity of distalization of 2.48 mm and 2.31 mm, 2.67 mm and 2.24 mm, 1.10 mm and 1.36 mm, 1.16 mm and 2.47 mm, was calculated for the first and second mandibular molars with reference to the VMP, VFH, CBCT coordinate system and CoGo planes respectively. A mean distalization quality of 5.86° and 6.61°, 46.3% and 26.2% was calculated for the first and second mandibular molars in angular value and tipping ratio respectively. A mean distalization stability of 0.17 mm and 0.42 mm, 0.22° and 0.84° was found for the first and second mandibular molars using the VFH plane and angular measurements respectively. A mean distalization limit of 1.53 mm, 2.70 mm and 1.81 mm was calculated with reference to the sagittal line, cuspid line and C-plane, respectively.
Conclusions: This meta-analysis demonstrated that mandibular molar distalization is effective, with a threshold value of 2.70 ± 0.52 mm accepted as the limit for translational movement. However, it is recommanded that a CBCT scan calculating the individualised threshold value be performed each time the mandibular distalization protocol is indicated.