Distalización del primer molar superioranálisis sobre el estado actual

Résumé

Introduction: there are many techniques that perform distalization of upper molar: extraoral and intraoral appliances, more conventional methods and widely explored; and combination appliances with temporary anchorage devices, as miniscrews or miniplates; as well as clear aligner systems. Objetive: to analyze literature about advances in appliances able to perform upper molar distalization and to research about dental and skeletal changes they do. Material and methods: search was focused on randomized clinical trials. Different databases, as Pubmed, Scopus, Web of Science, Cochrane and Ebsco, and impact Orthodontic journals were reviewed. To analyze risk of bias, RoB 2 tool was used. Results: 2028 articles were initially found. Only 12 studies fulfilled inclusion criteria, out of which 3 included miniscrews, and none about clear aligners. Risk of bias was high in almost all included studies. Discussion: heterogeneity exists between cephalometric parameters in the studies, that make hard to compare. All appliances had a grade of clockwise rotation of the mandible and point A retrusion. Conventional appliances are generally effective in upper molar distalization, but they have secondary effects such anterior anchorage loss and molar tipping. This secondary effect seems to be reduced with the use of miniscrews. Conclusions: more randomized clinical trials are needed to show the efficacy oftemporary anchorage devices and clear aligners in distalization of upper molar.