Distalización del primer molar superior: péndulo de Hilgers, distal jet y barra transpalatina con microtornillosrevisión sistemática

Abstract

Introduction: The objective of this study was to systematically evaluate the available scientific evidence that relates the distalization of the first upper molars and the loss of anchorage of the anterior teeth through devices reinforced with TAD’s on the palate such as the Hilgers pendulum, distal jet and transpalat bar. Material and method: An electronic search of the databases was carried out: Embase, Scopus, PubMed, Web of Science, Google Scholar Beta, OpenGrey and Pqdt Open. Unpublished literature and on-going studies were also verified electronically through ClinicalTrials. gov and Ictrp. The analytical review is comprised between the years 2006-2018. The work followed the PRISMA statement. Results: The primary result shows a greater distalization in mass and in tipping of the Hilgers pendulum with TAD’s in the maxilla of the first molar (4.8 ± 1.5 mm), counteracting the reaction effect of the anterior anchorage loss with an evident retrusion of the central incisor (0.9 ± 0.1 mm), with a significant difference of P < 0.05, compared to a treatment with devices such as the distal screw (3.6 ± 1.5 mm and 0.1 ± 0.1 mm) of mass distalization and retrusion of the upper incisor; and the transpalatal bar with mini-screws (3.7 ± 1.5 mm and 0.1 ± 0.2 mm) of mass distalization and retrusion of the upper incisor. The secondary results can be considered as: absence of pain, little alteration of the chewing and gingival recession, with in one case unwanted movement of the TAD’s and no iatrogenic damage to the root. Conclusion: The Hilgers pendulum with TAD’s allows greater distalization in mass of the first upper molar and a greater retrusion of the upper incisor with respect to the distal screw and the transpalatal bar.