{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T01:53:07Z","timestamp":1775785987882,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordination for the Improvement of Higher Education Personnel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,31]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Intraoral distalizers are effective and conservative alternatives for Class II malocclusion treatment. However, the literature is still controversial regarding the effects of using skeletal anchorage in intraoral distalizers with different designs. The aim of this study is to compare dentoskeletal and soft-tissue changes of Class II malocclusion patients treated with three types of First Class (FC) distalizers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials\/Methods<\/jats:title><jats:p>The sample of this prospective clinical trial included 30 consecutive patients divided into three groups: G1\u2014FC conventionally anchored; G2\u2014FC skeletally anchored Type 1; G3\u2014FC skeletally anchored Type 2. Each group consisted of 10 patients. Lateral cephalograms were analyzed in two stages: at pre-treatment (T0) and after distalization (T1). The radiographs were digitized and analyzed using the software Dolphin Imaging 11.5. Comparisons of treatment changes between groups (T1\u2013T0) were performed using one-way analysis of variance (ANOVA), followed by the Tukey test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients treated with the conventionally anchored FC showed significantly greater incisors protrusion and labial inclination, second premolars mesial inclination and mesialization than the FCs skeletally anchored. No differences were observed regarding the amount of molar distalization and molar angulation between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Limitations<\/jats:title><jats:p>It can be considered that the limitation of this study lies in its non-randomized design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions\/Implications<\/jats:title><jats:p>First Class distalizers with conventional and skeletal anchorage are effective alternatives for Class II molar distalization. Distalization associated with indirect skeletal anchorage reduce the undesirable effects observed in the incisors and premolars during distalization when compared to distalization conventionally anchored.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejo\/cjac065","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T20:32:05Z","timestamp":1667593925000},"page":"150-156","source":"Crossref","is-referenced-by-count":5,"title":["Dentoskeletal and soft-tissue changes of class II malocclusion treatment with modified first class appliances: a prospective clinical trial"],"prefix":"10.1093","volume":"45","author":[{"given":"Carolina Caetano","family":"Anraki","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo , Bauru , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2695-625X","authenticated-orcid":false,"given":"C\u00e1ssio Bernard Alves","family":"Campos","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan , Ann Arbor , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel Querobim","family":"Sant\u2019Anna","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo , Bauru , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7785-1634","authenticated-orcid":false,"given":"Silvio Augusto","family":"Bellini-Pereira","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan , Ann Arbor , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3963-1742","authenticated-orcid":false,"given":"Aron","family":"Aliaga-Del Castillo","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo , Bauru , Brazil"},{"name":"Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan , Ann Arbor , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Grec","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo , Bauru , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Fernando Castanha","family":"Henriques","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo , Bauru , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Garib","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo , Bauru , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"2023033115535155200_","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.ajodo.2012.10.015","article-title":"Correction of Class II malocclusion with Class II elastics: a systematic review","volume":"143","author":"Janson","year":"2013","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2023033115535155200_","first-page":"91","article-title":"Evaluation of cervical anchorage force in treatment","volume":"31","author":"Kloehn","year":"1961","journal-title":"The Angle Orthodontist"},{"key":"2023033115535155200_","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ajodo.2018.06.011","article-title":"Understanding factors influencing compliance with removable functional appliances: a qualitative study","volume":"155","author":"El-Huni","year":"2019","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2023033115535155200_","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.2319\/101507-406.1","article-title":"Maxillary molar distalization with noncompliance intramaxillary appliances in Class II malocclusion. 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