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June's Tip: Moving Molars Back with a PENDEX Appliance

By: Dr. Michel Champagne

By: Dr. Michel Champagne

In earlier info letters we have discussed many techniques for moving back molars (see the molar distalization section). The recent come back in popularity for the PENDULUM or  PENDEX appliance makes me reopen the topic. The PENDULUM AND PENDEX were both developped by Dr. Hilgers many years ago. As discussed earlier, molar distalization can be a logical option to correct a dental class 2 by 4-5mm. Even if in situations, correcting more than half a bicuspid is feasable, going to this extent, the clinician should expect some secondary effects: molar tipping, molar palatal deviation, loss of anterior anchorage, etc. Obviously, the clinician has to question himsel or herself on the other options available when there is a complete class 2 molar occlusion: forward mandibular repositioning if the profile commands it or even bicuspids extractions in very specific cases. Let us come back to the PENDEX and the indications for it’s use:

1.     Need of transverse development and this should be done first

2.     Moving back molar(s) by 4-5mm over 2 or 3 activations to preserve anchorage.

3.     Molar derotation

We must avoid reaching half objectives which means not finishing in full molar class 1, doing so would compromise occlusal stability.

 

Comments by Dr. Alan Macdonald. With the Pendulum the Wilson loops must be opened as molars are distalized otherwise the distal “arc” of the apparatus will bring them lingual as appears in this example case. Re unlocking no question, especially in mixed dentition pre pubertal growth.

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