Evaluation of the effectiveness of maxillary molar distalization using clear aligners in combination with micro-implants: a randomized controlled trial

BACKGROUND: One of the most difficult tasks in clear aligner treatment is maintaining anchorage during molar distalization. Traditional anchorage methods often lead to unwanted side effects in the anterior segment. AIM: To analyze the effectiveness of maxillary molar distalization using clear aligners and to optimize this treatment protocol based on a comparative analysis of clinical results obtained with the standard protocol versus a protocol using micro-implants. METHODS: A total of 40 patients with Class II malocclusion were examined and treated. The patients were divided into two groups: the study group (aligners + micro-implants) and the control group (aligners + Class II elastics). Results were evaluated based on cone-beam computed tomography data and superposition of 3D jaw models. RESULTS: In the study group, bodily molar movement of 3.2 ± 0.4 mm was achieved without loss of anchorage. In the control group, incisor protrusion (average 2.3°) and distal crown tipping (tipping) of the molars were observed. CONCLUSION: The integration of micro-implants into the aligner treatment protocol provides predictable results and minimizes dependence on patient compliance. Skeletal anchorage provides absolute anchorage, preventing undesirable incisor protrusion and ensuring bodily control of molar movement. The use of this technique increases the predictability of digital planning and reduces the dependence of treatment outcomes on patient compliance with elastic wear.