Upper Molar Distalisation is an effective treatment modality in

Class II correction cases.

Based on the current literature how many mm can be predictably achieved in each case?

RCT study done by Garino et al. had a sample size of 30 non-growing patients.

Placed into two experimental groups

Group A: 5 Vertical attachments (7/6/5/4/3)

Group B: 3 Vertical attachments (6/5/4)

All patients were instructed to:

•Wear their aligners for 22+ hours/day

•4.5oz 3/16” Class II Elastics (full time)

•Changing aligners trays every 2 weeks

•V-shaped staging pattern

Upper Molar Distalisation had achieved:

~2-2.5mm Distalisation

~1mm Intrusion

What about Group A and Group B differences?

Group A showed no significant tipping movement but more intrusion (p<.001)

Group B showed unfortunately significant tipping of the first molar (p<.05)

Conclusion

Garino et al. concluded the 5 Attachment pattern (group A) appears to be more effective in molar Distalisation, decreasing amount of tipping, molar extrusion, anterior anchorage loss & undesirable changes in LFH.

Achievable Distalisation was around ~1.5-2.3mm

About 2mm of Upper Molar Distalisation is achievable

accompanied by slight molar crown distal tipping

Achievable Upper Molar Distalisation of 2.25mm

without significant tipping