{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T09:43:00Z","timestamp":1783762980075,"version":"3.55.0"},"reference-count":74,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:\u2002<\/jats:title>\n                    <jats:p>To evaluate and compare skeletal effects and the amount of molar distalization in maxilla using modified palatal anchorage plate (MPAP) vs headgear appliances in adolescent patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:\u2002<\/jats:title>\n                    <jats:p>Pre- and posttreatment lateral cephalograms of 45 Class II malocclusion patients were analyzed; 24 were treated with MPAP appliances (age, 12.4 years) and 21 with headgear (age, 12.1 years). Fixed orthodontic treatment started with the distalization process in both groups. Thirty-two variables were measured and compared between both groups using multivariate analysis of covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:\u2002<\/jats:title>\n                    <jats:p>\n                      There was no significant main effect of the appliance type on the treatment results (\n                      <jats:italic>P<\/jats:italic>\n                      \u200a=\u200a .063). Also, there was no significant main effect of the appliance type on both pre- and posttreatment comparisons (\n                      <jats:italic>P<\/jats:italic>\n                      \u200a=\u200a .0198 and .135, respectively). The MPAP and headgear groups showed significant distalization of maxillary first molars (3.06 \u00b1 0.54 mm and 1.8 \u00b1 0.58 mm, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Sagittal skeletal maxillomandibular differences were improved after treatment (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), with no significant differences between the two groups. No significant difference in treatment duration was found between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:\u2002<\/jats:title>\n                    <jats:p>The MPAP showed a significant skeletal effect on the maxilla. Both MPAP and headgear resulted in distalization of maxillary first molars. Therefore, it is recommended that clinicians consider the application of MPAP, especially in noncompliant Class II patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/060114-392.1","type":"journal-article","created":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T09:32:37Z","timestamp":1409909557000},"page":"657-664","source":"Crossref","is-referenced-by-count":40,"title":["Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents"],"prefix":"10.2319","volume":"85","author":[{"given":"Noor Laith","family":"Sa'aed","sequence":"first","affiliation":[{"name":"Graduate student, Department of Dentistry, College of Medicine, The Catholic University of Korea, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Ook","family":"Park","sequence":"additional","affiliation":[{"name":"Private practice, Clinical Professor at Department of Orthodontics, The Catholic University of Korea; Seoul National University; and Korea University, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Bayome","sequence":"additional","affiliation":[{"name":"Research Assistant Professor, Department of Dentistry, College of Medicine, The Catholic University of Korea, Seoul, Korea, and Visiting Professor, Department of Postgraduate Studies, Universidad Auton\u00f3ma del Paraguay, Asunci\u00f3n, Paraguay."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Associate Professor and Chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, AT Still University, Mesa, Ariz, and Adjunct Professor, the Graduate School of Dentistry, Kyung Hee University, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YoonJi","family":"Kim","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon-Ah","family":"Kook","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"r1","series-title":"Angle Orthod","first-page":"56","article-title":"Orthodontics\u2014force or persuasion","volume":"23","author":"Kloehn\n              SJ.","year":"1953","unstructured":"Kloehn\n              SJ. \n          \n          Orthodontics\u2014force or persuasion. Angle Orthod. 1953;23:56\u201365."},{"key":"r2","series-title":"Am J Orthod Dentofacial Orthop","first-page":"228","article-title":"Effect of maxillary anteroposterior position on profile esthetics in headgear-treated patients","volume":"139","author":"Mann\n              KR,","year":"2011","unstructured":"Mann\n              KR, \n            \n              Marshall\n              SD, \n            \n              Qian\n              F, \n            \n              Southard\n              KA, \n            \n              Southard\n              TE. \n          \n          Effect of maxillary anteroposterior position on profile esthetics in headgear-treated patients. Am J Orthod Dentofacial Orthop. 2011;139:228\u2013234."},{"key":"r3","series-title":"Angle Orthod","first-page":"57","article-title":"Upper headgear versus lower headgear, yokes, and Class III elastics","volume":"48","author":"Osvaldik-Trapl\n              M,","year":"1978","unstructured":"Osvaldik-Trapl\n              M, \n            \n              Droschl\n              H. \n          \n          Upper headgear versus lower headgear, yokes, and Class III elastics. Angle Orthod. 1978;48:57\u201361."},{"key":"r4","series-title":"Am J Orthod","first-page":"8","article-title":"The influence of extraoral traction","volume":"53","author":"Poulton\n              DR.","year":"1967","unstructured":"Poulton\n              DR. \n          \n          The influence of extraoral traction. 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Angle Orthod. 2002;72:481\u2013494."},{"key":"r8","series-title":"Am J Orthod Dentofacial Orthop","first-page":"353","article-title":"A comparison of two intraoral molar distalization appliances: distal jet versus pendulum","volume":"128","author":"Chiu\n              PP,","year":"2005","unstructured":"Chiu\n              PP, \n            \n              McNamara\n              JA\n              Jr, \n            \n              Franchi\n              L. \n          \n          A comparison of two intraoral molar distalization appliances: distal jet versus pendulum. Am J Orthod Dentofacial Orthop. 2005;128:353\u2013365."},{"key":"r9","series-title":"Am J Orthod Dentofacial Orthop","first-page":"698e1","article-title":"Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty","volume":"135","author":"Baccetti\n              T,","year":"2009","unstructured":"Baccetti\n              T, \n            \n              Franchi\n              L, \n            \n              Stahl\n              F. \n          \n          Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty. 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Eur J Orthod. 2008;30:558\u2013571."},{"key":"r13","series-title":"Angle Orthod","first-page":"838","article-title":"Intraosseous screw-supported upper molar distalization","volume":"74","author":"Gelgor\n              IE,","year":"2004","unstructured":"Gelgor\n              IE, \n            \n              Buyukyilmaz\n              T, \n            \n              Karaman\n              AI, \n            \n              Dolanmaz\n              D, \n            \n              Kalayci\n              A. \n          \n          Intraosseous screw-supported upper molar distalization. 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Korean J Orthod. 1999;29:699\u2013706."},{"key":"r16","series-title":"J Clin Orthod","first-page":"417","article-title":"Micro-implant anchorage for treatment of skeletal Class I bialveolar protrusion","volume":"35","author":"Park\n              HS,","year":"2001","unstructured":"Park\n              HS, \n            \n              Bae\n              SM, \n            \n              Kyung\n              HM, \n            \n              Sung\n              JH. \n          \n          Micro-implant anchorage for treatment of skeletal Class I bialveolar protrusion. J Clin Orthod. 2001;35:417\u2013422."},{"key":"r17","series-title":"Am J Orthod Dentofacial Orthop","first-page":"470","article-title":"Treatment effects of microimplant-aided sliding mechanics on distal retraction of posterior teeth","volume":"139","author":"Oh\n              YH,","year":"2011","unstructured":"Oh\n              YH, \n            \n              Park\n              HS, \n            \n              Kwon\n              TG. \n          \n          Treatment effects of microimplant-aided sliding mechanics on distal retraction of posterior teeth. Am J Orthod Dentofacial Orthop. 2011;139:470\u2013481."},{"key":"r18","series-title":"Inf Orthod Kieferorthop","first-page":"251","article-title":"Ein neues Titan-Flachschrauben-Implantat zur orthodontischen Verankerung am anterioren Gaumen","volume":"24","author":"Triaca\n              A,","year":"1992","unstructured":"Triaca\n              A, \n            \n              Antonini\n              M, \n            \n              Wintermantel\n              E. \n          \n          Ein neues Titan-Flachschrauben-Implantat zur orthodontischen Verankerung am anterioren Gaumen. Inf Orthod Kieferorthop. 1992;24:251\u2013257."},{"key":"r19","series-title":"J Clin Pediatr Dent","first-page":"405","article-title":"Palatal soft tissue thickness at different ages using an ultrasonic device","volume":"36","author":"Lee\n              SM,","year":"2012","unstructured":"Lee\n              SM, \n            \n              Park\n              JH, \n            \n              Bayome\n              M, \n            \n              Kim\n              HS, \n            \n              Mo\n              SS, \n            \n              Kook\n              YA. \n          \n          Palatal soft tissue thickness at different ages using an ultrasonic device. J Clin Pediatr Dent. 2012;36:405\u2013409."},{"key":"r20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"207","article-title":"Palatal bone thickness compared with cone-beam computed tomography in adolescents and adults for mini-implant placement","volume":"142","author":"Ryu\n              JH,","year":"2012","unstructured":"Ryu\n              JH, \n            \n              Park\n              JH, \n            \n              Vu Thi Thu\n              T, \n            \n              Bayome\n              M, \n            \n              Kim\n              Y, \n            \n              Kook\n              YA. \n          \n          Palatal bone thickness compared with cone-beam computed tomography in adolescents and adults for mini-implant placement. Am J Orthod Dentofacial Orthop. 2012;142:207\u2013212."},{"key":"r21","series-title":"Angle Orthod","first-page":"625","article-title":"Evaluation of palatal bone density in adults and adolescents for application of skeletal anchorage devices","volume":"82","author":"Han\n              S,","year":"2012","unstructured":"Han\n              S, \n            \n              Bayome\n              M, \n            \n              Lee\n              J, \n            \n              Lee\n              YJ, \n            \n              Song\n              HH, \n            \n              Kook\n              YA. \n          \n          Evaluation of palatal bone density in adults and adolescents for application of skeletal anchorage devices. Angle Orthod. 2012;82:625\u2013631."},{"key":"r22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"47","article-title":"Treatment effects of a modified palatal anchorage plate for distalization evaluated with cone-beam computed tomography","volume":"146","author":"Kook\n              YA,","year":"2014","unstructured":"Kook\n              YA, \n            \n              Bayome\n              M, \n            \n              Trang\n              VT, \n            et al. \n          Treatment effects of a modified palatal anchorage plate for distalization evaluated with cone-beam computed tomography. 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Korean J Orthod. 2013;43:101\u2013109."},{"key":"r30","series-title":"Angle Orthod","first-page":"960","article-title":"Facial profile changes in early Class II correction with cervical headgear","volume":"77","author":"Kirjavainen\n              M,","year":"2007","unstructured":"Kirjavainen\n              M, \n            \n              Hurmerinta\n              K, \n            \n              Kirjavainen\n              T. \n          \n          Facial profile changes in early Class II correction with cervical headgear. 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Angle Orthod. 2013;83:735\u2013742."},{"key":"r33","series-title":"J Orofac Orthop","first-page":"118","article-title":"Treatment efficiency of mini-implant-borne distalization depending on age and second-molar eruption","volume":"75","author":"Nienkemper\n              M,","year":"2014","unstructured":"Nienkemper\n              M, \n            \n              Wilmes\n              B, \n            \n              Pauls\n              A, \n            \n              Yamaguchi\n              S, \n            \n              Ludwig\n              B, \n            \n              Drescher\n              D. \n          \n          Treatment efficiency of mini-implant-borne distalization depending on age and second-molar eruption. J Orofac Orthop. 2014;75:118\u2013132."},{"key":"r34","series-title":"Angle Orthod","first-page":"923","article-title":"Intraoral maxillary molar distalization","volume":"76","author":"Karlsson\n              I,","year":"2006","unstructured":"Karlsson\n              I, \n            \n              Bondemark\n              L. \n          \n          Intraoral maxillary molar distalization. Angle Orthod. 2006;76:923\u2013929."},{"key":"r35","series-title":"Am J Orthod Dentofacial Orthop","first-page":"66","article-title":"Distal movement of the maxillary molars","volume":"114","author":"Gianelly\n              AA.","year":"1998","unstructured":"Gianelly\n              AA. \n          \n          Distal movement of the maxillary molars. 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Am J Orthod Dentofacial Orthop. 2011;139:228\u2013234."},{"key":"r3","series-title":"Angle Orthod","first-page":"57","article-title":"Upper headgear versus lower headgear, yokes, and Class III elastics","volume":"48","author":"Osvaldik-Trapl\n              M,","year":"1978","unstructured":"Osvaldik-Trapl\n              M, \n            \n              Droschl\n              H. \n          \n          Upper headgear versus lower headgear, yokes, and Class III elastics. Angle Orthod. 1978;48:57\u201361."},{"key":"r4","series-title":"Am J Orthod","first-page":"8","article-title":"The influence of extraoral traction","volume":"53","author":"Poulton\n              DR.","year":"1967","unstructured":"Poulton\n              DR. \n          \n          The influence of extraoral traction. Am J Orthod. 1967;53:8\u201318."},{"key":"r5","series-title":"Eur J Orthod","first-page":"175","article-title":"Social inequality and discontinuation of orthodontic treatment: is there a link","volume":"25","author":"Turbill\n              EA,","year":"2003","unstructured":"Turbill\n              EA, \n            \n              Richmond\n              S, \n            \n              Wright\n              JL. \n          \n          Social inequality and discontinuation of orthodontic treatment: is there a link? 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Angle Orthod. 2002;72:481\u2013494."},{"key":"r8","series-title":"Am J Orthod Dentofacial Orthop","first-page":"353","article-title":"A comparison of two intraoral molar distalization appliances: distal jet versus pendulum","volume":"128","author":"Chiu\n              PP,","year":"2005","unstructured":"Chiu\n              PP, \n            \n              McNamara\n              JA\n              Jr, \n            \n              Franchi\n              L. \n          \n          A comparison of two intraoral molar distalization appliances: distal jet versus pendulum. Am J Orthod Dentofacial Orthop. 2005;128:353\u2013365."},{"key":"r9","series-title":"Am J Orthod Dentofacial Orthop","first-page":"698e1","article-title":"Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty","volume":"135","author":"Baccetti\n              T,","year":"2009","unstructured":"Baccetti\n              T, \n            \n              Franchi\n              L, \n            \n              Stahl\n              F. \n          \n          Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty. 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Am J Orthod Dentofacial Orthop. 1996;110:639\u2013646."},{"key":"r12","series-title":"Eur J Orthod","first-page":"558","article-title":"Treatment effects of intraoral appliances with conventional anchorage designs for non-compliance maxillary molar distalization: a literature review","volume":"30","author":"Kinzinger\n              GS,","year":"2008","unstructured":"Kinzinger\n              GS, \n            \n              Eren\n              M, \n            \n              Diedrich\n              PR. \n          \n          Treatment effects of intraoral appliances with conventional anchorage designs for non-compliance maxillary molar distalization: a literature review. 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Am J Orthod Dentofacial Orthop. 2011;139:470\u2013481."},{"key":"r18","series-title":"Inf Orthod Kieferorthop","first-page":"251","article-title":"Ein neues Titan-Flachschrauben-Implantat zur orthodontischen Verankerung am anterioren Gaumen","volume":"24","author":"Triaca\n              A,","year":"1992","unstructured":"Triaca\n              A, \n            \n              Antonini\n              M, \n            \n              Wintermantel\n              E. \n          \n          Ein neues Titan-Flachschrauben-Implantat zur orthodontischen Verankerung am anterioren Gaumen. 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Am J Orthod Dentofacial Orthop. 1998;114:66\u201372."},{"key":"r36","series-title":"Eur J Orthod","first-page":"43","article-title":"Molar distalization by intra-oral force application","volume":"13","author":"Jeckel\n              N,","year":"1991","unstructured":"Jeckel\n              N, \n            \n              Rakosi\n              T. \n          \n          Molar distalization by intra-oral force application. 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