Non-Compliance Distalization Appliances Supported by Mini-Implants: A Systematic Review

Background: A common strategy for the correction of Class II malocclusion is to initially distalize the maxillary molars to create a Class I relationship. Material and Methods: PubMed, Embase, Cochrane Library, Google Scholar, and Clinicaltrials.gov databases were searched to identify and retrieve orthodontic articles that evaluated non-compliance distalization appliances supported by mini-implants up to 11 November 2022. Results: A total of 505 articles were initially identified, and after applying the inclusion criteria, 28 studies were enlisted for evaluation. For the prospective studies, the Risk of bias in non-randomized studies of interventions assessment tool was used, and for the retrospective studies, the Newcastle-Ottawa quality assessment scale. Regarding the palatal devices with mini-implants, the maxillary molars were distalized with a mean value ranging from 2.4 to 5.9 mm, along with a distal tipping ranging between 0.01 degrees and 11 degrees, while when Pendulums were used with mini-implants, the maxillary molars were distalized with a mean value from 1.8 mm to 7.9 mm, and the distal tipping ranged from 7.34 degrees to 22.8 degrees. Further, in the second subgroup, including the appliances placed buccally, the maxillary molars were distalized with a mean value ranging from 1.83 mm to 4.2 mm and a distal tipping ranging between 0.6 degrees and 4.8 degrees. Conclusions: Non-compliance appliances supported by mini-implants are effective in maxillary molar distalization, presenting no anchorage loss of the anterior dental unit in most of the appliances, while distal tipping was found to be more pronounced when the mini-implants were used with Pendulums.