Identification of key determinant for predicting feasible mandibular molars distalization

Background/purpose: The distal movement of mandibular molar is effective treatment strategy, while it is still difficult to determine if the posterior available space is sufficient or not for mandibular molar distalization before treatment. Thus, this study aimed to identify the measurement items of lateral cephalograms with the potential to accurately predict the posterior anatomical limit of mandibular molar distalization.
Materials and methods: Cephalometric images of 26 patients were used. We establish five landmarks: the distal contact point (D7), the distal root apex (R7), the distal tooth cervix (TC) of the mandibular second molar, the anterior border of the ramus (ABR) and the external oblique line of the mandible (E). The D7-ABR and the vertical height between TC and E (TC-V), the distal movements of D7 and R7 during treatment (D7D, R7D) were measured. The subjects were divided into bodily-like and tipping movement group, according to the ratio D7D/R7D.
Results: Significant differences in D7D and R7D were found between the bodily-like movement and tipping movement groups (P < 0.01). Moreover, TC-V was significantly larger in the bodily-like movement group (P < 0.01). A positive correlation was found between TC-V and D7D (r = 0.68) and between TC-V and R7D (r = 0.69), indicating that TC-V has the potential to make accurate predictions for D7D and R7D. D7-ABR did not show a positive correlation with R7D.
Conclusion: Using TC-V can strengthen the prediction of available posterior space for mandibular molar distalization.

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