Displacement pattern of the anterior segment using antero-posterior lingual retractor combined with a palatal plate

Objective: To evaluate and compare the effects of two appliances on the en masse retraction of the anterior teeth anchored by temporary skeletal anchorage devices (TSADs). Methods: The sample comprised 46 nongrowing hyperdivergent adult patients who planned to undergo upper first premolar extraction using lingual retractors. They were divided into three groups, based on the lingual appliance used: the C-lingual retractor (CLR) group (group 1, n = 16) and two antero-posterior lingual retractor (APLR) groups (n = 30, groups 2 and 3). The APLR group was divided by the posterior tube angulation; posterior tube parallel to the occlusal plane (group 2, n = 15) and distally tipped tube (group 3, n = 15). A retrospective clinical investigation of the skeletal, dental, and soft tissue relationships was performed using lateral cephalometric radiographs obtained pretreatment and post en masse retraction of the anterior teeth. Results: All groups achieved significant incisor and canine retraction. The upper posterior teeth did not drift significantly during the retraction period. The APLR group had less angulation change in the anterior dentition, compared to the CLR group. By changing the tube angulation in the APLR, the intrusive force significantly increased in the distally tipped tube of group 3 patients and remarkably reduced the occlusal plane angle. Conclusions: Compared to the CLR, the APLR provides better anterior torque control and canine tipping while achieving bodily translation. Furthermore, changing the tube angulation will affect the amount of incisor intrusion, even in patients with similar palatal vault depth, without the need for additional TSADs.