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∏ Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ
¿Óˆ ÁÔÌÊ›ˆÓ
™. ™π¢∏ƒ√¶√À§√À*, π. ™. ¶∞¶∞°∂øƒ°π√À**
* ∂›ÎÔ˘ÚË ∫·ıËÁ‹ÙÚÈ·, ∂ÚÁ·ÛÙ‹ÚÈÔ √ÚıÔ‰ÔÓÙÈ΋˜, ∆Ì‹Ì· √‰ÔÓÙÈ·ÙÚÈ΋˜, ∞ÚÈÛÙÔÙ¤ÏÂÈÔ ¶·ÓÂÈÛÙ‹ÌÈÔ £ÂÛÛ·ÏÔӛ΢.
** √ÚıÔ‰ÔÓÙÈÎfi˜, ÀÔ„‹ÊÈÔ˜ ¢È‰¿ÎÙˆÚ, ∂ÚÁ·ÛÙ‹ÚÈÔ √ÚıÔ‰ÔÓÙÈ΋˜, ∆Ì‹Ì· √‰ÔÓÙÈ·ÙÚÈ΋˜, ∞ÚÈÛÙÔÙ¤ÏÂÈÔ ¶·ÓÂÈÛÙ‹ÌÈÔ £ÂÛÛ·ÏÔӛ΢.

The use of the Pendulum appliance for distal movement

of first maxillary molars
S. SIDIROPOULOU*, I. S. PAPAGEORGIOU**
* Assistant Professor, Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
** Orthodontist, Doctorate Degree Candidate, Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.

¶EPI§HæH ABSTRACT

™ÙÔ ¿ÚıÚÔ ·˘Ùfi Á›ÓÂÙ·È ·Ó·Ï˘ÙÈ΋ ·ÚÔ˘Û›·ÛË Ù˘ Û˘Û΢‹˜ This paper describes in details the Pendulum appliance and its
Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ use for the distal movement of first maxillary molars. This
Î·È ÂÚÈÁÚ¿ÊÂÙ·È Ë ‰Ú¿ÛË Ù˘. ∏ Û˘Û΢‹ ·˘Ù‹ ·ÚÔ˘ÛÈ¿˙ÂÈ ÙÔ appliance has the advantage that it does not require patient
ÏÂÔÓ¤ÎÙËÌ· fiÙÈ ‰ÂÓ ··ÈÙ› ÙË Û˘ÓÂÚÁ·Û›· ÙÔ˘ ·ÛıÂÓ‹ Î·È ÂÈ- compliance and achieves significant distal movement of
Ù˘Á¯¿ÓÂÈ ÛËÌ·ÓÙÈ΋ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ·ÏÏ¿ Î·È ÙˆÓ maxillary first as well as of second permanent molars. Its effect
‰Â‡ÙÂÚˆÓ ¿Óˆ ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ. ∏ Â›‰Ú·Û‹ Ù˘ Â›Ó·È Î˘Ú›ˆ˜ is mainly dentoalveolar, but indirect effects, mostly skeletal,
Ô‰ÔÓÙÔÊ·ÙÓȷ΋ ·ÏÏ¿ ¤¯Ô˘Ó ·Ú·ÙËÚËı› Î·È ¤ÌÌÂÛ˜ Âȉڿ- have also been observed on the vertical dimension. The
ÛÂȘ, ÛÎÂÏÂÙÈΤ˜, ΢ڛˆ˜ ÛÙË Î·Ù·ÎfiÚ˘ÊË ‰È¿ÛÙ·ÛË. ∏ Û˘Û΢‹ Pendulum appliance is a reliable alternative for the distal
Pendulum ·ÔÙÂÏ› ¤Ó· ·ÍÈfiÈÛÙÔ Ì¤ÛÔ ÂÈÏÔÁ‹˜ ÁÈ· ÙËÓ ¿ˆ movement of first maxillary molars.
ÌÂٷΛÓËÛË ÙˆÓ ¿Óˆ ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ. KEY WORDS: Pendulum appliance, distalization of maxillary
§∂•∂π™ ∫§∂π¢π∞: ™˘Û΢‹ Pendulum, ¿ˆ ÌÂٷΛÓËÛË ÚÒÙˆÓ first molars, Class ππ malocclusion.
¿Óˆ ÁÔÌÊ›ˆÓ, Û˘ÁÎÏÂÈÛȷ΋ ·ÓˆÌ·Ï›· ∆¿Í˘ ππ. Hel. Orthod. Rev. 2002; 5: 49-59
∂ÏÏ. √ÚıÔ‰. ∂Èı. 2002; 5: 49-59 Received: 06.10.1999 - Accepted: 23.12.1999
¶·ÚÂÏ‹ÊıË: 06.10.1999 – ŒÁÈÓ ‰ÂÎÙ‹: 23.12.1999

EI™A°ø°H INTRODUCTION

∆Ô ÈÔ Û˘¯Ófi ›Ûˆ˜ Úfi‚ÏËÌ· ÙÔ ÔÔ›Ô Î·ÏÂ›Ù·È Ó· ·ÓÙÈ- The most common problem that the orthodontist
ÌÂÙˆ›ÛÂÈ Ô ÔÚıÔ‰ÔÓÙÈÎfi˜ ÛÙËÓ Î·ıËÌÂÚÈÓ‹ ÎÏÈÓÈ΋ routinely faces in clinical practice is the distal
Ú¿ÍË Â›Ó·È Ë ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÌfiÓÈÌˆÓ movement of first maxillary permanent molars. In
ÁÔÌÊ›ˆÓ. ™ÙËÓ ÔÚıÔ‰ÔÓÙÈ΋ ‚È‚ÏÈÔÁÚ·Ê›· ·Ó·Ê¤ÚÔ- achieving this goal, a variety of means are reported
ÓÙ·È ÔÏÏÔ› ÙÚfiÔÈ ÁÈ· ÙËÓ Â›Ù¢ÍË ·˘ÙÔ‡ ÙÔ˘ ·ÔÙÂϤ- in the orthodontic literature, such as the use of extra-
ÛÌ·ÙÔ˜ fiˆ˜ Ë ¯Ú‹ÛË Â͈ÛÙÔÌ·ÙÈÎÔ‡ ÙfiÍÔ˘ ‹ ÎÈÓËÙÒÓ oral forces or removable appliances that,
Û˘Û΢ÒÓ Ô˘ ··ÈÙÔ‡Ó fï˜ ÙË Û˘ÓÂÚÁ·Û›· ÙÔ˘ ·ÛıÂ- nevertheless, require patient compliance (Haack and
Ó‹ (Haack Î·È Weinstein, 1958; Hersey Î·È Û˘Ó., Weinstein, 1958; Hersey et al., 1981; Ritto, 1995;
1981; Ritto, 1995; Cetlin Î·È Ten Hoeve, 1983; Cetlin and Ten Hoeve, 1983; Proffit 1980). This fact
Proffit, 1980). ∆Ô ÁÂÁÔÓfi˜ ·˘Ùfi Ô‰‹ÁËÛ ÛÙËÓ ÂÈÓfiË- resulted in the introduction of different fixed intraoral
ÛË ‰È¿ÊÔÚˆÓ ·Î›ÓËÙˆÓ ÂÓ‰ÔÛÙÔÌ·ÙÈÎÒÓ Û˘Û΢ÒÓ ÔÈ appliances for the same purpose which, however,

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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∂ÈÎfiÓ· 1. ∏ Û˘Û΢‹ Pendulum ¤Íˆ ·fi ÙËÓ ÛÙÔÌ·ÙÈ΋ ÎÔÈ- ∂ÈÎfiÓ· 2. ∏ Û˘Û΢‹ Pendulum ÙÔÔıÂÙË̤ÓË ÛÙÔ ÛÙfiÌ·.
ÏfiÙËÙ· Ì ÂÓÂÚÁÔÔÈË̤ӷ ÂÏ·Ù‹ÚÈ· ÁÈ· ¿ˆ ÌÂٷΛÓËÛË ∆ÔÔı¤ÙËÛË ÙˆÓ ÂÏ·ÙËÚ›ˆÓ ÛÙÔ˘˜ ÛˆÏËÓ›ÛÎÔ˘˜ ÙˆÓ ÁÔÌ-
ÙˆÓ ¿Óˆ ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ. Ê›ˆÓ.

Figure 1. The Pendulum appliance with the springs activated Figure 2. Intraoral view of the Pendulum. Spring engagement
for distal maxillary molar movement. in the molar sheaths.

Ôԛ˜ fï˜ ›¯·Ó ·fi ÂÌ‚ÈÔÌ˯·ÓÈ΋ ¿Ô„Ë ÔÚÈṲ̂- presented certain biomechanical side effects (Carano
Ó˜ ·ÚÂÓ¤ÚÁÂȘ (Carano Î·È Testa, 1996; Gianelly and Testa, 1996; Gianelly et al., 1991; Wilson and
Î·È Û˘Ó., 1991; Wilson Î·È Wilson, 1984; Jones Î·È Wilson, 1984; Jones and White, 1992; Locatelly et
White, 1992; Locatelly Î·È Û˘Ó., 1992; Reiner, al., 1992; Reiner, 1992; Jeckel and Rakosi, 1991).
1992; Jeckel Î·È Rakosi, 1991). One of the modern means for the distal movement of
ŒÓ· ·fi Ù· Û‡Á¯ÚÔÓ· ̤۷ ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ first upper permanent molars is the Pendulum
ÚÒÙˆÓ ¿Óˆ ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ Â›Ó·È Ë Û˘Û΢‹ appliance (Figures 1 and 2), which was first
Pendulum (∂ÈÎfiÓ˜ 1 Î·È 2) Ë ÔÔ›· ÂÚÈÁÚ¿ÊËΠ·fi described by Hilgers in 1992. The name of this
ÙÔÓ Hilgers ÙÔ 1992. ∆Ô fiÓÔÌ· Ù˘ Û˘Û΢‹˜ appliance is derived from the swinging movement that
(Pendulum = ÂÎÎÚÂ̤˜) ÚÔ¤Ú¯ÂÙ·È ·fi ÙËÓ Î›ÓËÛË is performed by the springs from the mid-palatal line
Ù·Ï¿ÓÙˆÛ˘ ÙËÓ ÔÔ›· ÂÎÙÂÏÔ‡Ó Ù· ÂÏ·Ù‹ÚÈ· ·fi ÙËÓ to the palatal sheaths of molar bands. This appliance
̤ÛË ÁÚ·ÌÌ‹ Ù˘ ˘ÂÚÒ·˜ ¤ˆ˜ ÙÔ˘˜ ˘ÂÚÒÈÔ˘˜ ÛˆÏË- is considered an improvement on an older appliance
Ó›ÛÎÔ˘˜ ÙˆÓ ‰·ÎÙ˘Ï›ˆÓ ÙˆÓ ÁÔÌÊ›ˆÓ. ∏ Û˘Û΢‹ ·˘Ù‹ introduced by Hilgers for maxillary expansion and
ıˆÚÂ›Ù·È ÂͤÏÈÍË ÌÈ·˜ ·ÏÈfiÙÂÚ˘ Û˘Û΢‹˜ ÙÔ˘ ÂÈ- simultaneous rotation and distal movement of first
ÓÔËÙ‹ Ù˘ ÁÈ· ‰È‡ڢÓÛË Ù˘ ¿Óˆ ÁÓ¿ıÔ˘ Î·È Ù·˘Ùfi- upper molars (Hilgers, 1991).
¯ÚÔÓË ÛÙÚÔÊ‹ Î·È ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌ-
Ê›ˆÓ (Hilgers, 1991).
INDICATIONS AND
CONTRAINDICATIONS
EN¢EI•EI™ KAI ANTEN¢EI•EI™
The use of the Pendulum appliance is indicated in the
∏ ÂÊ·ÚÌÔÁ‹ Ù˘ Û˘Û΢‹˜ Pendulum ÂӉ›ÎÓ˘Ù·È ÛÙȘ following cases:
ÂÍ‹˜ ÂÚÈÙÒÛÂȘ: (a) Lack of space in the upper dental arch due to
(·) ŒÏÏÂÈ„Ë ¯ÒÚÔ˘ ÛÙÔ ¿Óˆ Ô‰ÔÓÙÈÎfi ÙfiÍÔ ·fi ÂÁÁ‡˜ mesial movement of first upper molars.
ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ. (b) Class II, division 1 malocclusions (Figures 3 and 4)
(‚) ™˘ÁÎÏÂÈÛȷο ÚÔ‚Ï‹Ì·Ù· ∆¿Í˘ ππ, 1˘ ηÙËÁÔÚ›·˜ or Class II, division 2 malocclusions.
(∂ÈÎfiÓ˜ 3 Î·È 4) ‹ ∆¿Í˘ ππ, 2˘ ηÙËÁÔÚ›·˜. (c) Patients who are non-compliant with the use of

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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∂ÈÎfiÓ˜ 3 Î·È 4. ™˘ÁÎÏÂÈÛȷ΋ ·ÓˆÌ·Ï›· ∆¿Í˘ ππ, 1˘ ηÙËÁÔÚ›·˜ Ì ¤Ó‰ÂÈÍË ÁÈ· ÂÊ·ÚÌÔÁ‹ Ù˘ Û˘Û΢‹˜ Pendulum.

Figures 3 and 4. Case of Class II, division 1 malocclusion with indication for Pendulum use.

(Á) ¶Úfi‚ÏËÌ· ÛÙËÓ Û˘ÓÂÚÁ·Û›· ÙÔ˘ ·ÛıÂÓ‹ ÁÈ· ÙËÓ headgear (extra-oral forces).
ÂÊ·ÚÌÔÁ‹ Â͈ÛÙÔÌ·ÙÈÎÔ‡ ÙfiÍÔ˘. The main contraindication of Pendulum application is
∫‡ÚÈ· ·ÓÙ¤Ó‰ÂÈÍË ÂÊ·ÚÌÔÁ‹˜ Ù˘ Û˘Û΢‹˜ Pendulum a tendency for anterior open bite or the presence of
·ÔÙÂÏ› Ë Ù¿ÛË ÁÈ· ÚfiÛıÈ· ·ÓˆÁ̤ÓË ‰‹ÍË ‹ Ë increased lower anterior facial height with tendency
‡·ÚÍË ·˘ÍË̤ÓÔ˘ οو ÚfiÛıÈÔ˘ ‡„Ô˘˜ ÙÔ˘ ÚÔÛÒ- for posterior mandibular rotation (Hilgers, 1992). In
Ô˘ Ì Ô›ÛıÈ· ÛÙÚÔÊ‹ Ù˘ οو ÁÓ¿ıÔ˘ (Hilgers, the view of several authors, this appliance should not
1992). ∏ ÂÊ·ÚÌÔÁ‹ Ù˘ Û˘Û΢‹˜ Pendulum ·ÓÙÂӉ›- be used in cases of severe skeletal Class II (Byloff et
ÎÓ˘Ù·È Â›Û˘, Û‡Ìʈӷ Ì ÔÚÈṲ̂ÓÔ˘˜ ÂÚ¢ÓËÙ¤˜, fiÙ·Ó al., 1997; Gosh and Nanda, 1996).
˘¿Ú¯ÂÈ ¤ÓÙÔÓË ∆¿ÍË ππ ÛÎÂÏÂÙÈ΋˜ ·ÈÙÈÔÏÔÁ›·˜ (Byloff
Î·È Û˘Ó., 1997; Gosh Î·È Nanda, 1996).
DESCRIPTION OF THE
APPLIANCE
¶EPI°PAºH TH™ ™Y™KEYH™
∏ Û˘Û΢‹ Pendulum (∂ÈÎfiÓ˜ 1 Î·È 2) ·ÔÙÂÏÂ›Ù·È ·fi The Pendulum (Figures 1 and 2) includes a passive
¤Ó· ·ıËÙÈÎfi Î·È ·fi ¤Ó· ÂÓÂÚÁËÙÈÎfi ÙÌ‹Ì·. and an active component.
∆Ô ·ıËÙÈÎfi ÙÌ‹Ì· Ù˘ Û˘Û΢‹˜ ·ÔÙÂÏÂ›Ù·È ·fi ÌÈ· ÙÚÔ- The passive component of the appliance is a
ÔÔÈË̤ÓË Ͽη Nance Ë ÔÔ›· ÛÙËÚ›˙ÂÙ·È ÛÙÔ˘˜ ÚÒ- modified Nance button cemented onto first upper
ÙÔ˘˜ ÚÔÁfiÌÊÈÔ˘˜ Ù˘ ¿Óˆ ÁÓ¿ıÔ˘ (∂ÈÎfiÓ˜ 1, 2 Î·È 5). premolars (Figures 1, 2 and 5). In the Pendulum, the
™ÙË Û˘Û΢‹ Pendulum Ë ·ÎÚ˘ÏÈ΋ Ͽη Á›ÓÂÙ·È fiÛÔ ÙÔ acrylic plate is constructed so as to cover the largest
‰˘Ó·Ùfi ÌÂÁ·Ï‡ÙÂÚË ¤ÙÛÈ ÒÛÙ ӷ ÂÌÔ‰›˙ÂÙ·È Ô ÙÚ·˘Ì·ÙÈ- possible area in order to avoid trauma of the soft
ÛÌfi˜ ÙˆÓ Ì·Ï·ÎÒÓ ÈÛÙÒÓ Ù˘ ˘ÂÚÒ·˜ ηٿ ÙËÓ ÌÂٷΛÓË- palatal tissues during upper molar movement. It
ÛË ÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ. ¶Ú¤ÂÈ Ó· ·¤¯ÂÈ ÂÚ›Ô˘ 5 ¯ÈÏ. should have a 5-mm clearance from the teeth so as
·fi Ù· ‰fiÓÙÈ· ÁÈ· Ó· ·ÔʇÁÂÈ ÙÔ ·ÁÁÂÈ·Îfi ‰›ÎÙ˘Ô Ô˘ to avoid the adjacent vascular network and allow for
‚Ú›ÛÎÂÙ·È ÎÔÓÙ¿ Û ·˘Ù¿ Î·È Ó· ÂÈÙÚ¤ÂÈ ÙÔÓ Î·ı·ÚÈÛÌfi tooth cleaning (Figure 5).
ÙÔ˘˜ (∂ÈÎfiÓ· 5). ∏ ÛÙËÚÈÎÙÈ΋ ÌÔÓ¿‰· ÌÔÚ› Ó· ÂÓÈÛ¯˘- The anchorage unit can be further reinforced with the
ı› ÂÈϤÔÓ Ì ÚÔÛı‹ÎË ·ÁΛÛÙÚˆÓ ÛÙÔ˘˜ ‰Â‡ÙÂÚÔ˘˜ addition of brackets on the second primary molars or
ÓÂÔÁÈÏÔ‡˜ ÁÔÌÊ›Ô˘˜ ‹ ÚÔÁfiÌÊÈÔ˘˜ (Hilgers, 1992). premolars (Hilgers, 1992).

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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∂ÈÎfiÓ· 5. ∂Ê·ÚÌÔÁ‹ Ù˘ Û˘Û΢‹˜ Pendulum ÁÈ· ÙËÓ ¿ˆ ∂ÈÎfiÓ· 6. ¢Ú¿ÛË ÌÂÙ¿ ·fi 3 ‚‰ÔÌ¿‰Â˜. ∂·ÓÂÓÂÚÁÔÔ›ËÛË.
ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ. ∂ÓÂÚÁÔÔ›ËÛË ÙˆÓ
ÂÏ·ÙËÚ›ˆÓ Ì ÁˆÓ›· ÂÚ›Ô˘ 45Æ. Figure 6. Appliance effect after 3 weeks. Reactivation.

Figure 5. Application of the Pendulum for distal molar

movement. Spring activation at a 45Æ angle.

∏ Û˘Û΢‹ ÂÚÈÏ·Ì‚¿ÓÂÈ ‰‡Ô ÂÏ·Ù‹ÚÈ· Ù· ÔÔ›· ÂÓÛˆ- The appliance includes two springs incorporated in
Ì·ÙÒÓÔÓÙ·È ÛÙÔ Ô›ÛıÈÔ ÙÌ‹Ì· Ù˘ ·ÎÚ˘ÏÈ΋˜ Ͽη˜ the posterior part of the acrylic plate almost parallel to
ۯ‰fiÓ ·Ú¿ÏÏËÏ· ÚÔ˜ ÙË Ì¤ÛË ˘ÂÚÒÈ· Ú·Ê‹ (∂ÈÎfi- the mid-palatal suture (Figures 1 and 5). The free ends
Ó˜ 1 Î·È 5). ∆Ô ÂχıÂÚÔ ¿ÎÚÔ ÙˆÓ ÂÏ·ÙËÚ›ˆÓ ·˘ÙÒÓ of these springs are engaged in the molar sheaths
ÂÊ·ÚÌfi˙ÂÈ ÛÙÔ˘˜ ÛˆÏËÓ›ÛÎÔ˘˜ ÙˆÓ ÁÔÌÊ›ˆÓ (∂ÈÎfiÓ· 6) (Figure 6), thus applying the forces necessary for distal
ÂÍ·ÛÎÒÓÙ·˜ ¤ÙÛÈ ÙȘ ··Ú·›ÙËÙ˜ ‰˘Ó¿ÌÂȘ ÁÈ· ÙËÓ ¿ˆ molar movement.
ÌÂٷΛÓËÛË ÙˆÓ ÁÔÌÊ›ˆÓ. Appliance springs are constructed with TMA wire,
∆· ÂÏ·Ù‹ÚÈ· ÙÔ˘ Ì˯·Ó‹Ì·ÙÔ˜ ηٷÛ΢¿˙ÔÓÙ·È ·fi because this wire is characterized by low load-
Û‡ÚÌ· ∆ª∞, ÂÂȉ‹ ·˘Ùfi ÙÔ Û‡ÚÌ· ¤¯ÂÈ ¯·ÌËÏfi ÏfiÁÔ deflection ratio and great elasticity in comparison to
ÊÔÚÙ›Ô˘-·Ú·ÌfiÚʈÛ˘ Î·È ÌÂÁ¿ÏË ÂÏ·ÛÙÈÎfiÙËÙ· Û stainless steel wires, thus allowing for long activation
Û¯¤ÛË Ì ٷ Û‡ÚÌ·Ù· ·fi ·ÓÔÍ›‰ˆÙÔ ¯¿Ï˘‚· ÂÈÙÚ¤Ô- with low forces.
ÓÙ·˜ ÌÂÁ¿Ï˜ ÂÓÂÚÁÔÔÈ‹ÛÂȘ Ì ÌÈÎÚ¤˜ ‰˘Ó¿ÌÂȘ. The springs consist of a horizontal part engaged in the
∆· ÂÏ·Ù‹ÚÈ· ·ÔÙÂÏÔ‡ÓÙ·È ·fi ¤Ó· ÔÚÈ˙fiÓÙÈÔ ÙÌ‹Ì· ÙÔ palatal sheaths of molar bands, a small horizontal
ÔÔ›Ô ÂÈÛ¤Ú¯ÂÙ·È ÛÙÔ˘˜ ˘ÂÚÒÈÔ˘˜ ÛˆÏËÓ›ÛÎÔ˘˜ ÙˆÓ adjustment loop, a closed spiral loop and a loop for
‰·ÎÙ˘Ï›ˆÓ ÙˆÓ ÁÔÌÊ›ˆÓ, ÌÈ· ÌÈÎÚ‹ ÔÚÈ˙fiÓÙÈ· ·Á·ÏË ÚÔ- the retention of the spring within the acrylic (Figures 5
Û·ÚÌÔÁ‹˜, ÌÈ· ÎÏÂÈÛÙ‹ ÂÏÈÎÔÂȉ‹ ·Á·ÏË Î·ıÒ˜ Î·È ÌÈ· and 6). According to Hilgers (1992), springs should
·Á·ÏË Û˘ÁÎÚ¿ÙËÛ˘ ÙÔ˘ ÂÏ·ÙËÚ›Ô˘ ÛÙÔ ·ÎÚ˘ÏÈÎfi (∂ÈÎfi- be positioned as close as possible to the center of the
Ó˜ 5 Î·È 6). ™‡Ìʈӷ Ì ÙÔÓ Hilgers (1992) Ù· ÂÏ·Ù‹- acrylic plate, whereas loop formation is performed as
ÚÈ· Ú¤ÂÈ Ó· Â›Ó·È ÙÔÔıÂÙË̤ӷ fiÛÔ ÙÔ ‰˘Ó·Ùfi ÈÔ near as possible to the distal part of the acrylic plate
ÎÔÓÙ¿ ÛÙÔ Î¤ÓÙÚÔ Ù˘ ˘ÂÚÒÈ·˜ Ͽη˜, ÂÓÒ Ë ‰È·ÌfiÚ- in order to allow easy access to the acrylic so as to
ʈÛË ÙˆÓ ·Á΢ÏÒÓ ÙÔ˘˜ Á›ÓÂÙ·È fiÛÔ ÙÔ ‰˘Ó·Ùfi ÈÔ ÎÔÓÙ¿ facilitate cleaning. The springs should be as close as
ÛÙÔ ¿ˆ ÙÌ‹Ì· Ù˘ ˘ÂÚÒÈ·˜ Ͽη˜ ¤ÙÛÈ ÒÛÙ ӷ ÂÈ- possible to the center of the acrylic plate so as to:
ÙÚ¤ÂÙ·È Ë ¿ÓÂÙË ÚfiÛ‚·ÛË ÛÙÔ ·ÎÚ˘ÏÈÎfi ÁÈ· ηı·ÚÈfi- - increase their range of action to the maximum;
ÙËÙ·. ∏ ÙÔÔı¤ÙËÛË ÙˆÓ ÂÏ·ÙËÚ›ˆÓ fiÛÔ ÙÔ ‰˘Ó·Ùfi ÈÔ - allow for their easy engagement in the palatal
ÎÔÓÙ¿ ÛÙÔ Î¤ÓÙÚÔ Ù˘ ˘ÂÚÒÈ·˜ Ͽη˜ Á›ÓÂÙ·È ¤ÙÛÈ ÒÛÙÂ: sheath of molar bands, and
- Ó· ·˘ÍËı›, ηٿ ÙÔ ‰˘Ó·Ùfi, Ë ·ÎÙ›Ó· ‰Ú¿Û˘ ÙÔ˘˜, - reduce forces to an acceptable level.
- Ó· ÂÈÙÚ¤ÂÙ·È Ë Â‡ÎÔÏË Â›ÛÔ‰fi˜ ÙÔ˘˜ ÛÙÔÓ ˘ÂÚÒÈÔ Spring activation is most efficiently performed before

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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ÛˆÏËÓ›ÛÎÔ ÙˆÓ ‰·ÎÙ˘Ï›ˆÓ ÙˆÓ ÁÔÌÊ›ˆÓ, Î·È the appliance is placed in the mouth. If significant
- Ó· ÌÂȈıÔ‡Ó ÔÈ ‰˘Ó¿ÌÂȘ Û ¤Ó· ·Ô‰ÂÎÙfi Â›‰Ô. distal molar movement is desired, activated springs
∏ ÂÓÂÚÁÔÔ›ËÛË ÙˆÓ ÂÏ·ÙËÚ›ˆÓ Á›ÓÂÙ·È ÈÔ ·ÔÙÂÏÂÛÌ·- should be parallel to the mid-palatal suture or
ÙÈο ÚÈÓ Ë Û˘Û΢‹ ÙÔÔıÂÙËı› ÛÙÔ ÛÙfiÌ·. ∂¿Ó ··È- perpendicular to the body of the appliance. Spring
ÙÂ›Ù·È ÛËÌ·ÓÙÈ΋ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ Ù· bending results in a 60Æ activation following their
ÂÏ·Ù‹ÚÈ· ı· Ú¤ÂÈ Ó· ÂÓÂÚÁÔÔÈËıÔ‡Ó ¤ÙÛÈ ÒÛÙ ӷ engagement in the palatal sheaths. According to
Â›Ó·È ·Ú¿ÏÏËÏ· ÛÙËÓ Ì¤ÛË ˘ÂÚÒÈ· Ú·Ê‹ ‹ οıÂÙ· Hilgers (1992), one third of the activation is lost upon
ÛÙÔ ÛÒÌ· Ù˘ Û˘Û΢‹˜. ∏ Î¿Ì„Ë ·˘Ù‹ ÙˆÓ ÂÏ·ÙËÚ›ˆÓ spring engagement in the palatal sheaths of molar
ÚÔηÏ› ÂÓÂÚÁÔÔ›ËÛË 60Æ ÌÂÙ¿ ÙËÓ Â›ÛÔ‰fi ÙÔ˘˜ bands and residual pressure is well tolerated by the
ÛÙÔ˘˜ ˘ÂÚÒÈÔ˘˜ ÛˆÏËÓ›ÛÎÔ˘˜. ™‡Ìʈӷ Ì ÙÔÓ patient. On the other hand, Byloff and Darendeliler
Hilgers (1992) ηٿ ÙËÓ ÙÔÔı¤ÙËÛË ÙˆÓ ÂÏ·ÙËÚ›ˆÓ (1995) apply a 45Æ activation (Figure 5); thus, further
ÛÙÔÓ ˘ÂÚÒÈÔ ÛˆÏËÓ›ÛÎÔ ÙˆÓ ‰·ÎÙ˘Ï›ˆÓ ÙˆÓ ÁÔÌÊ›ˆÓ activation is required during treatment. Besides, the
¯¿ÓÂÙ·È ÙÔ ¤Ó· ÙÚ›ÙÔ Ù˘ ÂÓÂÚÁÔÔ›ËÛ˘, Î·È Ë ÂÓ·Ô- distal molar movement also depends on the spring
̤ÓÔ˘Û· ›ÂÛË Á›ÓÂÙ·È Â‡ÎÔÏ· ·ÓÂÎÙ‹ ·fi ÙÔÓ ·ÛıÂÓ‹. angle of entry into the palatal sheath.
∞ÓÙ›ıÂÙ· ÔÈ Byloff Î·È Darendeliler (1995) ÂÓÂÚÁÔÔÈ- The appliance is activated before it is placed in the
Ô‡Ó Î·Ù¿ 45Æ (∂ÈÎfiÓ· 5) Ì ·ÔÙ¤ÏÂÛÌ· Ó· ¯ÚÂÈ¿˙ÔÓÙ·È mouth and is cemented onto the anchorage teeth.
ÂÚÈÛÛfiÙÂÚ˜ ÂÓÂÚÁÔÔÈ‹ÛÂȘ ηٿ ÙËÓ ‰È¿ÚÎÂÈ· Ù˘ Following cementation, the springs are engaged in
ıÂÚ·›·˜. ∂ÈϤÔÓ Ë Ù¿ÛË ÙˆÓ ÁÔÌÊ›ˆÓ Ó· ÌÂÙ·ÎÈÓË- the palatal sheaths with pliers and ligated with an
ıÔ‡Ó ÚÔ˜ Ù· ¿ˆ ÂÍ·ÚÙ¿Ù·È Î·È ·fi ÙËÓ ÁˆÓ›· ÂÈÛfi- elastic module or a steel ligature (Figure 2).
‰Ô˘ ÙÔ˘ ÂÏ·ÙËÚ›Ô˘ ÛÙÔÓ ˘ÂÚÒÈÔ ÛˆÏËÓ›ÛÎÔ. The magnitude of the force applied on the molars is
∏ Û˘Û΢‹ ÙÔÔıÂÙÂ›Ù·È ÛÙÔ ÛÙfiÌ· ÂÓÂÚÁÔÔÈË̤ÓË Î·È nearly 200-250 g. Treatment time with this appliance
Û˘ÁÎÔÏÏÂ›Ù·È ÛÙ· ‰fiÓÙÈ· ÛÙ‹ÚÈ͢. ªÂÙ¿ ÙÔ Ù¤ÏÔ˜ Ù˘ is approximately 4-6 months.
Û˘ÁÎfiÏÏËÛ˘ Ù· ÂÏ·Ù‹ÚÈ· ÙÔÔıÂÙÔ‡ÓÙ·È ÛÙÔÓ ˘ÂÚÒÈÔ
ÛˆÏËÓ›ÛÎÔ, Ì ÙËÓ ‚Ô‹ıÂÈ· ÌÈ·˜ ¤ÓÛ·˜ Î·È ÛÙ·ıÂÚÔ-
ÔÈÔ‡ÓÙ·È Ì ÂÏ·ÛÙÈ΋ ‹ Û˘ÚÌ¿ÙÈÓË ÚfiÛ‰ÂÛË (∂ÈÎfiÓ· APPLIANCE ACTIVATION
2). ∆Ô Ì¤ÁÂıÔ˜ ÙˆÓ ‰˘Ó¿ÌÂˆÓ Ô˘ ÂÍ·ÛÎÔ‡ÓÙ·È ÛÙÔ˘˜
ÁÔÌÊ›Ô˘˜ Â›Ó·È 200-250 g. ÂÚ›Ô˘. ∏ ‰È¿ÚÎÂÈ· The Pendulum is positioned in the patient’s mouth in an
ıÂÚ·›·˜ Ì ÙË Û˘Û΢‹ Â›Ó·È ÂÚ›Ô˘ 4-6 Ì‹Ó˜. activated state. At patient recall, the springs are
removed from the palatal sheaths to check on their
residual activation. Moving the spring towards the
ENEP°O¶OIH™H midline reactivates the appliance. Often, the
TH™ ™Y™KEYH™ adjustment loop does require activation, i.e., it is
opened to compensate for molar movement towards
∏ Û˘Û΢‹ Pendulum ÙÔÔıÂÙÂ›Ù·È ÛÙÔ ÛÙfiÌ· ÙÔ˘ ·ÛıÂ- the midline that may lead to cross-bite (Figure 6).
Ó‹ ÂÓÂÚÁÔÔÈË̤ÓË. ∫·Ù¿ ÙËÓ Â·ÓÂͤٷÛË ÙÔ˘ ·ÛıÂÓÔ‡˜
Ù· ÂÏ·Ù‹ÚÈ· ·ÔÛÔ‡ÓÙ·È ·fi ÙÔÓ ˘ÂÚÒÈÔ ÛˆÏËÓ›ÛÎÔ
Î·È ÂϤÁ¯ÂÙ·È Ë ›ÂÛË ÙÔ˘˜. ∂¿Ó ··ÈÙÂ›Ù·È Â·ÓÂÓÂÚÁÔ- APPLIANCE MODIFICATIONS
Ô›ËÛË ·˘Ù‹ Á›ÓÂÙ·È Ì ÌÂٷΛÓËÛË ÙÔ˘ ÂÏ·ÙËÚ›Ô˘ ÚÔ˜
ÙË Ì¤ÛË ÁÚ·ÌÌ‹. ™˘¯Ó¿ ¯ÚÂÈ¿˙ÂÙ·È ÂÓÂÚÁÔÔ›ËÛË, ‰ËÏ·- If additional expansion of the upper dental arch is
‰‹ ¿ÓÔÈÁÌ·, Ù˘ ·Á·Ï˘ ÚÔÛ·ÚÌÔÁ‹˜ ÒÛÙ ӷ ·ÓÙÈÚ- required, an expansion screw may be incorporated in
ÚÔÈÛı› Ë ÚÔ˜ ÙË Ì¤ÛË ÁÚ·ÌÌ‹ ÌÂٷΛÓËÛË ÙˆÓ ÁÔÌ- the appliance. This version of the appliance is known
Ê›ˆÓ Ô˘ Ô‰ËÁ› Û ÛÙ·˘ÚÔÂȉ‹ Û‡ÁÎÏÂÈÛË (∂ÈÎfiÓ· 6). as "Pend-X". One week following appliance
positioning, the expansion screw is activated one
TPO¶O¶OIH™EI™ quarter of a turn every three days in order to achieve
TH™ ™Y™KEYH™ slow, stable expansion.
Scuzzo et al. (1999) suggest that the horizontal loop
∂¿Ó ¯ÚÂÈ¿˙ÂÙ·È ÂÈϤÔÓ ‰È‡ڢÓÛË ÙÔ˘ ¿Óˆ Ô‰ÔÓÙÈÎÔ‡ of the appliance springs should be reversed to allow
ÙfiÍÔ˘ ÌÔÚ› Ó· ÂÓۈ̷وı› ÌÈ· ÂÍÂÏ›ÎÙÚ· ÛÙËÓ ·ÎÚ˘- for translation of first upper molars. This version of the
ÏÈ΋ Ͽη. ∏ ÂΉԯ‹ ·˘Ù‹ Ù˘ Û˘Û΢‹˜ ÔÓÔÌ¿˙ÂÙ·È appliance is known as "M-Pendulum".

E§§HNIKH OP£O¢ONTIKH E¶I£EøPH™H 2002 ñ TOMO™ 5 53 HELLENIC ORTHODONTIC REVIEW 2002 ñ VOLUME 5
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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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«Pend-X». ∏ ÂÍÂÏ›ÎÙÚ· ÂÓÂÚÁÔÔÈÂ›Ù·È ¤Ó· ٤ٷÚÙÔ Ù˘ To increase the anchorage capacity of the appliance,
ÛÙÚÔÊ‹˜ οı ÙÚÂȘ ̤Ú˜, ÌÈ· ‚‰ÔÌ¿‰· ÌÂÙ¿ ÙËÓ Gosh and Nanda (1996) recommend the inclusion of
ÙÔÔı¤ÙËÛË ÙÔ˘ Ì˯·Ó‹Ì·ÙÔ˜ ¤ÙÛÈ ÒÛÙ ӷ ÚÔηÏÂ›Ù·È canines and incisors in the anchorage unit and the
ÌÈ· ·ÚÁ‹ ÛÙ·ıÂÚ‹ ‰È‡ڢÓÛË. complete coverage of the palate with the acrylic plate.
√È Scuzzo Î·È Û˘Ó. (1999) ÚÔÙ›ÓÔ˘Ó ÙËÓ ·ÓÙÈÛÙÚÔÊ‹ Wong et al. (1999) use simple brackets for anchoring
Ù˘ ÔÚÈ˙fiÓÙÈ·˜ ·Á·Ï˘ ÙˆÓ ÂÏ·ÙËÚ›ˆÓ Ù˘ Û˘Û΢‹˜ the passive part of the appliance on the premolars.
¤ÙÛÈ ÒÛÙ ӷ ÂÈÙÚ¤ÂÈ ÙËÓ ·Ú¿ÏÏËÏË ÌÂٷΛÓËÛË ÙˆÓ
ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ. ∏ ÂΉԯ‹ ·˘Ù‹ Ù˘ Û˘Û΢‹˜
ÔÓÔÌ¿˙ÂÙ·È «M-Pendulum». EFFECTS OF THE PENDULUM
°È· Ó· ·˘ÍËı› Ë ÛÙËÚÈÎÙÈ΋ ÈηÓfiÙËÙ· Ù˘ Û˘Û΢‹˜ ÔÈ APPLIANCE
Gosh Î·È Nanda (1996) Û˘ÓÈÛÙÔ‡Ó Ó· ÂÚÈÏ·Ì‚¿ÓÔÓÙ·È
ÛÙËÓ ÛÙ‹ÚÈÍË ÔÈ Î˘Ófi‰ÔÓÙ˜ Î·È ÔÈ ÙÔÌ›˜ ηıÒ˜ Î·È Ó· Á›ÓÂ- The Pendulum acts on the teeth and the alveolar
Ù·È Ï‹Ú˘ Î¿Ï˘„Ë Ù˘ ˘ÂÚÒ·˜ ·fi ÙËÓ ·ÎÚ˘ÏÈ΋ Ͽη. processes on all three planes of space. Skeletal effects
√È Wong Î·È Û˘Ó. (1999) ¯ÚËÛÈÌÔÔÈÔ‡Ó ·Ï¿ ¿ÁÎÈ- have also been reported due to its use.
ÛÙÚ· ÁÈ· ÙËÓ ÛÙ‹ÚÈÍË ÛÙÔ˘˜ ÚÔÁfiÌÊÈÔ˘˜ ÙÔ˘ ·ıËÙÈÎÔ‡
̤ÚÔ˘˜ Ù˘ Û˘Û΢‹˜.
DENTOALVEOLAR EFFECT
Molar effect: Byloff and Darendeliler (1997) report
¢PA™H TH™ ™Y™KEYH™ that the distal movement of first maxillary molars
observed is, on average, 3.39 mm, Ghosh and
∏ Û˘Û΢‹ Pendulum Âȉڿ ÛÙ· ‰fiÓÙÈ· Î·È ÛÙ· ÙÚ›· Nanda (1996) report 3.37 mm, Byloff et al. (1997)
Â›‰· ÙÔ˘ ¯ÒÚÔ˘ ηıÒ˜ Î·È ÛÙȘ Ê·ÙÓȷΤ˜ ·Ôʇ- 4.14 mm (Fig. 7), whereas Bussick and McNamara
ÛÂȘ. ∞ӷʤÚÔÓÙ·È Â›Û˘ Î·È ÛÎÂÏÂÙÈΤ˜ ÂȉڿÛÂȘ (2000) report 5.7 mm of molar movement. The type
·fi ÙËÓ ¯Ú‹ÛË Ù˘. of movement observed is not translation, but a certain
degree of tipping (8.36Æ-14.50Æ). Byloff et al.
O¢ONTOºATNIAKH ¢PA™H (1997) claim that this tipping may be reduced by
∂›‰Ú·ÛË ÛÙÔ˘˜ ÁÔÌÊ›Ô˘˜: √È Byloff Î·È Darendeliler uprighting spring bends; nevertheless, treatment time
(1997) ·Ó·Ê¤ÚÔ˘Ó fiÙÈ Ë ·Ú·ÙËÚÔ‡ÌÂÓË ¿ˆ ÌÂٷΛ- with the Pendulum is increased by 64.1% while a
ÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ Â›Ó·È Î·Ù¿ ̤ÛÔ small additional anchorage loss at the upper incisor
fiÚÔ 3,39 ¯ÈÏ., ÔÈ Ghosh Î·È Nanda (1996) 3,37 region is also observed. Hilgers (1992) and Cobo et
¯ÈÏ., ÔÈ Byloff Î·È Û˘Ó. (1997) 4,14 ¯ÈÏ. (∂ÈÎ. 7), ÂÓÒ al. (1999) propose that distal molar movement should
ÔÈ Bussick Î·È McNamara (2000) 5,7 ¯ÈÏ. ∏ ÌÂٷΛ- be performed before eruption of second upper
ÓËÛË ·˘Ù‹ ‰ÂÓ Â›Ó·È ·Ú¿ÏÏËÏË ·ÏÏ¿ Á›ÓÂÙ·È Ì οÔÈ· molars; nevertheless, Ghosh and Nanda (1996) as
·fiÎÏÈÛË (8,36Æ-14,50Æ). √È Byloff Î·È Û˘Ó. (1997) well as Byloff and Darendeliler (1997) have showed
ÈÛ¯˘Ú›˙ÔÓÙ·È fiÙÈ Ë ·fiÎÏÈÛË ·˘Ù‹ ÌÔÚ› Ó· ÂÏ·ÙÙˆı› that the eruption stage of second molars has no effect
Â¿Ó Á›ÓÔ˘Ó Î¿Ì„ÂȘ ·ÓfiÚıˆÛ˘ ÛÙ· ÂÏ·Ù‹ÚÈ· ·ÏÏ¿ Ô on the magnitude of first upper molar distal movement.
¯ÚfiÓÔ˜ ıÂÚ·›·˜ Ì ÙË Û˘Û΢‹ Pendulum ·˘Í¿ÓÂÙ·È According to Ghosh and Nanda (1996), the eruption
ηٿ 64,1% ÂÓÒ ·Ú·ÙËÚÂ›Ù·È Î·È Ì›· ÌÈÎÚ‹ ÂÈϤÔÓ stage of second molars does not have any significant
·ÒÏÂÈ· ÛÙ‹ÚÈ͢ ÛÙËÓ ÂÚÈÔ¯‹ ÙˆÓ ¿Óˆ ÙÔ̤ˆÓ. ∞Ó Î·È effect on the anchorage unit either.
ÔÈ Hilgers (1992) Î·È Cobo Î·È Û˘Ó. (1999) Û˘ÓÈ- Hilgers (1992) reports that the effectiveness of distal
ÛÙÔ‡Ó Ë ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ Ó· molar movement is significantly enhanced if the Pend-
Á›ÓÂÙ·È ÚÈÓ ÙËÓ ·Ó·ÙÔÏ‹ ÙˆÓ ‰Â˘Ù¤ÚˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ, ÔÈ X appliance version is used, that is, if active
Ghosh Î·È Nanda (1996) Î·È Byloff Î·È Darendeliler expansion is performed simultaneously. On the
(1997) ¤‰ÂÈÍ·Ó fiÙÈ ÙÔ ÛÙ¿‰ÈÔ ·Ó·ÙÔÏ‹˜ ÙˆÓ ‰Â˘Ù¤ÚˆÓ contrary, the anchorage unit does not seem to be
ÁÔÌÊ›ˆÓ ‰ÂÓ ÂËÚ¿˙ÂÈ ÙÔ ÔÛfi Ù˘ ¿ˆ ÌÂٷΛÓËÛ˘ affected. Byloff et al. (1997), using a sample of 20
ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ. ™‡Ìʈӷ Ì ÙÔ˘˜ Class II patients, 8 individuals treated with the Pend-X
Gosh Î·È Nanda (1996) Ô‡Ù ·˘Ù‹ Ë ÛÙËÚÈÎÙÈ΋ ÌÔÓ¿- appliance and the remaining 12 with the standard
‰· ÂËÚ¿˙ÂÙ·È ÛËÌ·ÓÙÈο ·fi ÙÔ ÛÙ¿‰ÈÔ ·Ó·ÙÔÏ‹˜ ÙˆÓ Pendulum appliance, observed no difference in the
‰Â‡ÙÂÚˆÓ ÁÔÌÊ›ˆÓ. anchorage unit.

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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2.27 mm

1.17 nn
3.37-4.14 mm 1.63-2.55 mm
1.77 nn

∂ÈÎfiÓ· 7. ∂›‰Ú·ÛË Ù˘ Û˘Û΢‹˜ Pendulum ÛÙÔ˘˜ ÁÔÌÊ›- ∂ÈÎfiÓ· 8. ∂›‰Ú·ÛË Ù˘ Û˘Û΢‹˜ Pendulum ÛÙË ÛÙËÚÈÎÙÈ΋
Ô˘˜ (Byloff Î·È Darendeliler, 1997; Ghosh Î·È Nanda, 1996; ÌÔÓ¿‰· (Byloff Î·È Darendeliler, 1997; Ghosh Î·È Nanda,
Byloff Î·È Û˘Ó., 1997). 1996; Byloff Î·È Û˘Ó., 1997).

Figure 7. Pendulum effect on the molars (Byloff and Figure 8. Pendulum effect on the anchorage unit (Byloff and
Darendeliler, 1997; Ghosh and Nanda, 1996; Byloff et al., Darendeliler, 1997; Ghosh and Nanda, 1996; Byloff et al.,
1997). 1997).

√ Hilgers (1992) ·Ó·Ê¤ÚÂÈ fiÙÈ Ë ·ÔÙÂÏÂÛÌ·ÙÈÎfiÙËÙ· Second maxillary molars are moved with lesser distal
Ù˘ ¿ˆ ÌÂٷΛÓËÛ˘ ÙˆÓ ÁÔÌÊ›ˆÓ ·˘Í¿ÓÂÙ·È Î·Ù¿ Ôχ tipping than first molars, but they are also tipped
Â¿Ó ¯ÚËÛÈÌÔÔÈËı› Ë ÂΉԯ‹ Pend-X Ù˘ Û˘Û΢‹˜ buccally. Ghosh and Nanda (1996), examining a
Pendulum Ú·ÁÌ·ÙÔÔÈÒÓÙ·˜ ‰ËÏ·‰‹ Û˘Á¯ÚfiÓˆ˜ Î·È sample of 31 Class II patients, observe that second
ÂÓÂÚÁ‹ ‰È‡ڢÓÛË. ∞ÓÙ›ıÂÙ· Ë ÛÙËÚÈÎÙÈ΋ ÌÔÓ¿‰· ‰ÂÓ upper molars are moved distally over an average of
Ê·›ÓÂÙ·È Ó· ÂËÚ¿˙ÂÙ·È Î·ıfiÏÔ˘. √È Byloff Î·È Û˘Ó. 2.27 mm, whereas the effect of the appliance on
(1997) ‰È·ÈÛÙÒÓÔ˘Ó fiÙÈ ‰ÂÓ ˘¿Ú¯ÂÈ ‰È·ÊÔÚ¿ ÛÙË ÛÙË- third molars was minimal (Figure 7).
ÚÈÎÙÈ΋ ÌÔÓ¿‰·. ∞˘ÙÔ› ¯ÚËÛÈÌÔÔ›ËÛ·Ó ¤Ó· ‰Â›ÁÌ· 20 The Pendulum, besides distal molar movement, may
·ÙfiÌˆÓ ÌÂ Û˘ÁÎÏÂÈÛȷο ÚÔ‚Ï‹Ì·Ù· ∆¿Í˘ ππ ÂÎ ÙˆÓ further cause mild molar intrusion. Byloff and
ÔÔ›ˆÓ ÔÈ 8 ıÂÚ·‡ÙËÎ·Ó Ì ÙË Û˘Û΢‹ Pend-X ÂÓÒ Darendeliler (1997), in a sample of 13 individuals,
ÔÈ ˘fiÏÔÈÔÈ 12 Ì ÙËÓ Î·ÓÔÓÈ΋ Û˘Û΢‹ Pendulum. observe that first maxillary permanent molars are
√È ‰Â‡ÙÂÚÔÈ ¿Óˆ ÁÔÌÊ›ÔÈ ÌÂÙ·ÎÈÓÔ‡ÓÙ·È Ì ·fiÎÏÈÛË intruded at an average of 1.17 mm in reference to the
ÚÔ˜ Ù· ¿ˆ ÏÈÁfiÙÂÚÔ ·fi fiÙÈ ÔÈ ÚÒÙÔÈ ·ÏÏ¿ ÂÈϤ- occlusal plane (Figure 7). Bussick and McNamara
ÔÓ Î·È ·ÚÂȷο. √È Ghosh Î·È Nanda (1996) ÂÍÂÙ¿- (2000), in a sample of 101 patients, observed 0.7 mm
˙ÔÓÙ·˜ ¤Ó· ‰Â›ÁÌ· 31 ·ÛıÂÓÒÓ Ì ∆¿ÍË ππ ·Ú·ÙËÚÔ‡Ó of molar intrusion. First upper molar intrusion is attributed
fiÙÈ ÔÈ ‰Â‡ÙÂÚÔÈ ¿Óˆ ÁÔÌÊ›ÔÈ ÌÂÙ·ÎÈÓÔ‡ÓÙ·È ÚÔ˜ Ù· ¿ˆ to inhibition of the vertical growth of the alveolar
ηٿ ̤ÛÔ fiÚÔ 2,27 ¯ÈÏ. ÂÓÒ ÙÔ ·ÔÙ¤ÏÂÛÌ· Ù˘ ‰Ú¿- processes due to the fixed appliance and to the intrusive
Û˘ Ù˘ Û˘Û΢‹˜ ÛÙÔ˘˜ ÙÚ›ÙÔ˘˜ ÁÔÌÊ›Ô˘˜ ‹Ù·Ó Ôχ forces exercised by the tongue on the appliance.
ÌÈÎÚfi (∂ÈÎfiÓ· 7). The Pendulum also causes buccal tipping of maxillary
∂ÎÙfi˜ ·fi ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ molars. According to Ghosh and Nanda (1996), this
Ë Û˘Û΢‹ Pendulum ÌÔÚ› Ó· ÚÔηϤÛÂÈ ÂÈϤÔÓ buccal tipping is greater on second than first molars,
ÌÈÎÚ‹ ÂÌ‚‡ıÈÛ‹ ÙÔ˘˜. √È Byloff Î·È Darendeliler as well as on the mesiobuccal rather than the
(1997) ¯ÚËÛÈÌÔÔÈÒÓÙ·˜ ¤Ó· ‰Â›ÁÌ· 13 ·ÙfiÌˆÓ ·Ú·- distobuccal cusps. The mesiobuccal rotation of first
ÙËÚÔ‡Ó fiÙÈ ÔÈ ÚÒÙÔÈ ¿Óˆ ÌfiÓÈÌÔÈ ÁÔÌÊ›ÔÈ ÂÌ‚˘ı›˙ÔÓÙ·È molars has positive treatment effects, because it favors
ηٿ ̤ÛÔ fiÚÔ 1,17 ¯ÈÏ. Û ۯ¤ÛË Ì ÙÔ Û˘ÁÎÏÂÈÛÈ·Îfi good intercuspation between upper and lower molars
Â›Â‰Ô (∂ÈÎfiÓ· 7). √È Bussick Î·È McNamara and creates additional space because of the molar
(2000) Û ¤Ó· Ôχ ÌÂÁ·Ï‡ÙÂÚÔ ‰Â›ÁÌ· ·ÔÙÂÏÔ‡ÌÂÓÔ anatomy.
·fi 101 ·ÛıÂÓ›˜ ‚Ú›ÛÎÔ˘Ó ÂÌ‚‡ıÈÛË ›ÛË Ì 0,7 ¯ÈÏ. Effect on the anchorage unit: The Pendulum also acts
∏ ÂÌ‚‡ıÈÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ Û˘Ó‰¤ÂÙ·È ·ÊÂ- on the anchorage unit. Ghosh and Nanda (1996),

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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Ófi˜ ÌÂÓ Ì ÙËÓ ·Ó·ÛÙÔÏ‹ Ù˘ ηٷÎfiÚ˘Ê˘ ·‡ÍËÛ˘ ÙˆÓ Byloff and Darendeliler (1997) and Bussick and
Ê·ÙÓÈ·ÎÒÓ ·ÔʇÛÂˆÓ ·fi ÙËÓ ÛÙ·ıÂÚ‹ Û˘Û΢‹ ·ÊÂ- McNamara (2000) report that premolars move
Ù¤ÚÔ˘ Ì ÙȘ ‰˘Ó¿ÌÂȘ ÂÌ‚‡ıÈÛ˘ Ô˘ ÂÍ·ÛΛ Ë ÁÏÒÛ- mesially (1.63 mm – 2.55 mm) with tipping, while
Û· ÛÙÔ Ì˯¿ÓËÌ·. small extrusion is also observed. Maxillary incisors
∏ Û˘Û΢‹ Pendulum ÚÔηÏ› ÂÈϤÔÓ ·ÚÂȷ΋ also show small labial tipping (Ghosh and Nanda,
·fiÎÏÈÛË ÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ. ™‡Ìʈӷ Ì ÙÔ˘˜ Ghosh 1996) (Figure 8).
Î·È Nanda (1996) Ë ·fiÎÏÈÛË ·˘Ù‹ Â›Ó·È ÌÂÁ·Ï‡ÙÂÚË
ÛÙÔ˘˜ ‰Â‡ÙÂÚÔ˘˜ ·fi fiÙÈ ÛÙÔ˘˜ ÚÒÙÔ˘˜ ÁÔÌÊ›Ô˘˜
ηıÒ˜ Î·È ÛÙ· ÂÁÁ‡˜ ·ÚÂȷο ʇ̷ٷ ·fi fiÙÈ ÛÙ· ¿ˆ SKELETAL EFFECT
·ÚÂȷο. ∏ ÂÁÁ‡˜ ·ÚÂȷ΋ ÛÙÚÔÊ‹ ÙˆÓ ÚÒÙˆÓ ¿Óˆ No significant appliance effect is observed on the
ÌfiÓÈÌˆÓ ÁÔÌÊ›ˆÓ ¤¯ÂÈ ıÂÙÈο ·ÔÙÂϤÛÌ·Ù· ÛÙË ıÂÚ·- sagittal plane. On the contrary, there are conflicting
›· ÁÈ·Ù› ¢ÓÔ› ·ÊÂÓfi˜ ÌÂÓ ÙËÓ Û˘ÓÁfiÌʈÛË ÌÂٷ͇ views concerning its effect on the vertical plane.
ÙˆÓ ¿Óˆ Î·È Î¿Ùˆ ÁÔÌÊ›ˆÓ, ·ÊÂÙ¤ÚÔ˘ ‰Â ÂÍÔÈÎÔÓÔÌ› Hilgers (1992) stresses the tendency for open bite in
ÂÈϤÔÓ ¯ÒÚÔ ÏfiÁˆ Ù˘ ·Ó·ÙÔÌ›·˜ ÙÔ˘ ÁÔÌÊ›Ô˘. the anterior dental arch during distal molar movement.
∂›‰Ú·ÛË ÛÙË ÛÙËÚÈÎÙÈ΋ ÌÔÓ¿‰·: ∂›‰Ú·ÛË Ù˘ This open bite tendency is usually spontaneously
Û˘Û΢‹˜ ·Ú·ÙËÚÂ›Ù·È Â›Û˘ ÛÙË ÛÙËÚÈÎÙÈ΋ ÌÔÓ¿‰·. corrected in short-faced patients, whereas problems
√È Ghosh Î·È Nanda (1996), Byloff Î·È Darendeliler arise with long-faced patients, especially those with
(1997) Î·È Bussick Î·È McNamara (2000) ·Ó·Ê¤- abnormal swallowing patterns.
ÚÔ˘Ó fiÙÈ ÔÈ ÚÔÁfiÌÊÈÔÈ ÌÂÙ·ÎÈÓÔ‡ÓÙ·È ÚÔ˜ Ù· ÂÁÁ‡˜ Bussick and McNamara (2000) observed a 2.2 mm
(1,63 ¯ÈÏ.- 2,55 ¯ÈÏ.) Ì ·fiÎÏÈÛË, ÂÓÒ ·Ú·ÙËÚÂ›Ù·È increase of lower anterior facial height following
Û˘Á¯ÚfiÓˆ˜ Ì›· ÌÈÎÚ‹ ˘ÂÚ¤ÎÊ˘Û‹ ÙÔ˘˜. √È ¿Óˆ ÙÔÌ›˜ treatment with this appliance. These authors, in
·ÚÔ˘ÛÈ¿˙Ô˘Ó Â›Û˘ ÌÈ· ÌÈÎÚ‹ ¯ÂÈÏÈ΋ ·fiÎÏÈÛË contrast to Hilgers, claim that the increase is similar for
(Ghosh Î·È Nanda, 1996) (∂ÈÎfiÓ· 8). all vertical facial types.
Ghosh and Nanda (1996), after treatment with the
™KE§ETIKH ¢PA™H Pendulum, observe the following:
™ÙÔ Ô‚ÂÏÈ·›Ô Â›Â‰Ô ‰ÂÓ ·Ú·ÙËÚÂ›Ù·È ÛËÌ·ÓÙÈ΋ Â›- - small increase in lower anterior facial height (2.79),
‰Ú·ÛË Ù˘ Û˘Û΢‹˜. ∞ÓÙ›ıÂÙ· ÛÙÔ Î·Ù·ÎfiÚ˘ÊÔ Â›Â- - small increase in the mandibular plane angle by
‰Ô ÔÈ ·fi„ÂȘ ‰È›ÛÙ·ÓÙ·È. √ Hilgers (1992) ÂÈÛËÌ·›- 1.09Æ, and
ÓÂÈ ÙËÓ Ù¿ÛË ÁÈ· ·ÓˆÁ̤ÓË ‰‹ÍË ÛÙÔ ÚfiÛıÈÔ ÙÌ‹Ì· ÙÔ˘ - overbite decrease by an average 1.39 mm.
ÙfiÍÔ˘ ηٿ ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÁÔÌÊ›ˆÓ. ∏ Ù¿ÛË On the contrary, Byloff and Darendeliler (1997) found
·˘Ù‹ ‰ÈÔÚıÒÓÂÙ·È Û˘Ó‹ıˆ˜ ·˘ÙfiÌ·Ù· ÛÙÔ˘˜ ·ÛıÂÓ›˜ no significant appliance effect on the vertical plane,
Ì ‚Ú·¯‡ Ù‡Ô ÚÔÛÒÔ˘ ÂÓÒ ·ÓÙ›ıÂÙ· Â›Ó·È Úfi‚ÏËÌ· maybe because of first upper molar intrusion, which
ÛÙÔ˘˜ ·ÛıÂÓ›˜ Ì هÔ ÂÈÌ‹ÎÔ˘˜ ÚÔÛÒÔ˘, ȉ›ˆ˜ Û counterbalances any possible opening of the bite
·˘ÙÔ‡˜ Ì ·ÓÒÌ·ÏË Î·Ù¿ÔÛË. following the distal movement and tipping of the
√È Bussick Î·È McNamara (2000) ·Ú·ÙËÚÔ‡Ó ÌÈ· molars. Nevertheless, these authors note that it is
·‡ÍËÛË ÙÔ˘ οو ÚfiÛıÈÔ˘ ‡„Ô˘˜ ÙÔ˘ ÚÔÛÒÔ˘ ÌÂÙ¿ difficult to direct the vertical component of the force of
ÙË ıÂÚ·›· Ì ÙË Û˘Û΢‹ ›ÛË Ì 2,2 ¯ÈÏ. ∞ÓÙ›ıÂÙ· the Pendulum appliance.
fï˜ ·fi ÙÔÓ ÚÔËÁÔ‡ÌÂÓÔ Û˘ÁÁڷʤ· ÈÛ¯˘Ú›˙ÔÓÙ·È Conflicting views concerning appliance effects on the
fiÙÈ Ë ·‡ÍËÛË ·˘Ù‹ ÙÔ˘ οو ÚfiÛıÈÔ˘ ‡„Ô˘˜ ÙÔ˘ ÚÔ- vertical plane are possibly due to, on the one hand,
ÛÒÔ˘ Â›Ó·È ›‰È· Û fiÏÔ˘˜ ÙÔ˘˜ ηٷÎfiÚ˘ÊÔ˘˜ Ù‡Ô˘˜ different measurements used by different authors and,
ÙÔ˘ ÚÔÛÒÔ˘. on the other hand, the degree of molar intrusion
√È Ghosh Î·È Nanda (1996) ÌÂÙ¿ ÙÔ Ù¤ÏÔ˜ Ù˘ ıÂÚ·- during treatment, which directly depends on the type
›·˜ Ì ÙË Û˘Û΢‹ Pendulum ‚Ú›ÛÎÔ˘Ó ÌÈÎÚ‹ ·‡ÍËÛË of appliance activation. However, any increase of
ÙÔ˘ οو ÚfiÛıÈÔ˘ ‡„Ô˘˜ ÙÔ˘ ÚÔÛÒÔ˘ (2,79 ¯ÈÏ.), lower anterior facial height observed is small, ranging
ÌÈÎÚ‹ ·‡ÍËÛË Ù˘ ÁˆÓ›·˜ ÙÔ˘ ÂÈ¤‰Ô˘ Ù˘ οو ÁÓ¿ıÔ˘ between 2-3 mm. Nevertheless, in certain individuals
ηٿ 1,09Æ Î·È Ì›ˆÛË Ù˘ ηٷÎfiÚ˘Ê˘ ÂÈÎ¿Ï˘„˘ with excessive lower anterior facial height even this
ηٿ 1,39 ¯ÈÏ. ηٿ ̤ÛÔ fiÚÔ. small increase is undesirable. In these cases,
∞ÓÙ›ıÂÙ· ÔÈ Byloff Î·È Darendeliler (1997) ‰ÂÓ ‚Ú›- alternative therapeutic means should be used as
ÛÎÔ˘Ó Î¿ÔÈ· ÛËÌ·ÓÙÈ΋ Â›‰Ú·ÛË Ù˘ Û˘Û΢‹˜ ÛÙÔ reported in Pendulum appliance contraindications.

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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∂ÈÎfiÓ· 9. ¢Ú¿ÛË ÌÂÙ¿ ·fi 12 ‚‰ÔÌ¿‰Â˜. √ÏÔÎÏ‹ÚˆÛË Ù˘ ∂ÈÎfiÓ· 10. ªÂÙ·‚ÔϤ˜ ·fi ÙË ‰Ú¿ÛË Ù˘ Û˘Û΢‹˜
¿ˆ ÌÂٷΛÓËÛ˘ ÙˆÓ ÚÒÙˆÓ Î·È ‰Â‡ÙÂÚˆÓ ¿Óˆ ÌfiÓÈÌˆÓ Pendulum ·Ì¤Ûˆ˜ ÌÂÙ¿ ÙËÓ ·Ê·›ÚÂÛ‹ Ù˘.
ÁÔÌÊ›ˆÓ.
Figure 10. Changes due to the Pendulum appliance directly
Figure 9. Appliance effect after 12 weeks. Completion of after its removal.
distal movement of first and second maxillary permanent
molars.

ηٷÎfiÚ˘ÊÔ Â›Â‰Ô Èı·ÓfiÓ ÏfiÁˆ Ù˘ ÂÌ‚‡ıÈÛ˘ ÙˆÓ MOLAR RETENTION

ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ Ë ÔÔ›· ·ÓÙÈÚÚÔ› ÙÔ Èı·Ófi FOLLOWING DISTAL
¿ÓÔÈÁÌ· Ù˘ ‰‹Í˘ ÏfiÁˆ Ù˘ ¿ˆ ÌÂٷΛÓËÛ˘ Î·È ·fi- MOVEMENT
ÎÏÈÛ˘ ÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ. ¶·ÚfiÏ· ·˘Ù¿ ÔÈ ÚÔËÁÔ‡ÌÂ-
ÓÔÈ Û˘ÁÁÚ·Ê›˜ ·Ó·Ê¤ÚÔ˘Ó fiÙÈ ‰ÂÓ Â›Ó·È Â‡ÎÔÏÔ Ó· Following distal molar movement (Figures 9 and 10),
ηÙ¢ı‡ÓÔ˘Ì ÙȘ ηٷÎfiÚ˘Ê˜ Û˘ÓÈÛÙÒÛ˜ ÙˆÓ ‰˘Ó¿ÌÂ- molar retention and stabilization is performed with a
ˆÓ ÛÙË Û˘Û΢‹ Pendulum. TPA or a Nance acrylic plate anchored on first
√È ‰È·ÊÔÚÂÙÈΤ˜ ·fi„ÂȘ ÁÈ· ÙË ‰Ú¿ÛË Ù˘ Û˘Û΢‹˜ permanent molars (Figure 11). Retention may be
ÛÙÔ Î·Ù·ÎfiÚ˘ÊÔ Â›Â‰Ô Èı·ÓÒ˜ ÔÊ›ÏÔÓÙ·È ·ÊÂÓfi˜ reinforced with fixed appliances and continuous
ÌÂÓ ÛÙȘ ‰È·ÊÔÚÂÙÈΤ˜ ÌÂÙÚ‹ÛÂȘ Ô˘ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È archwire with omega loops mesial to the molars on
·fi ÙÔ˘˜ Û˘ÁÁÚ·Ê›˜ ·ÊÂÙ¤ÚÔ˘ ‰Â ÛÙËÓ ÂÌ‚‡ıÈÛË ‹ ÌË the upper dental arch or with a passive utility arch.
ÙˆÓ ÁÔÌÊ›ˆÓ ηٿ ÙË ‰È¿ÚÎÂÈ· Ù˘ ıÂÚ·›·˜ ÁÂÁÔÓfi˜ Treatment is completed with fixed orthodontic
Ô˘ ÂÍ·ÚÙ¿Ù·È ¿ÌÂÛ· ·fi ÙÔ ˆ˜ ÂÓÂÚÁÔÔÈÂ›Ù·È Ë appliances (Figure 12) to obtain full occlusal
Û˘Û΢‹. ¶·ÚfiÏ· ·˘Ù¿ Ë ·Ú·ÙËÚÔ‡ÌÂÓË ·‡ÍËÛË ÙÔ˘ relationships (Figure 13).
οو ÚfiÛıÈÔ˘ ‡„Ô˘˜ ÙÔ˘ ÚÔÛÒÔ˘, fiÙ·Ó ·˘Ù‹ ·Ó·-
ʤÚÂÙ·È, Â›Ó·È ÌÈÎÚ‹ ÌÂٷ͇ 2-3 ¯ÈÏ. ™Â ÔÚÈṲ̂ӷ ¿ÙÔÌ·
fï˜ Ì Ôχ ÌÂÁ¿ÏÔ Î¿Ùˆ ÚfiÛıÈÔ ‡„Ô˜ ÙÔ˘ ÚÔÛÒ- CONCLUSIONS
Ô˘ ·ÎfiÌ· Î·È ·˘Ù‹ Ë ·‡ÍËÛË ‰ÂÓ Â›Ó·È ÂÈı˘ÌËÙ‹. ™Â
·˘Ù¿ Ù· ¿ÙÔÌ· ı· Ú¤ÂÈ Ó· ÂÈϤÁÂÙ·È ¤Ó· ¿ÏÏÔ ıÂÚ·- Distal movement of first maxillary permanent molars
¢ÙÈÎfi ̤ÛÔ Î·È fi¯È Ë Û˘Û΢‹ Pendulum fiˆ˜ ·Ó·- with the Pendulum appliance is achieved in a short
ʤÚÂÙ·È ÛÙȘ ·ÓÙÂӉ›ÍÂȘ Ù˘ Û˘Û΢‹˜. time. The presence of second maxillary molars in the
dental arch creates no problem during this movement,
since second molars also move distally. When the
™Y°KPATH™H TøN °OMºIøN Pendulum is used, patient cooperation is not required.
META THN A¶ø METAKINH™H The effect of the appliance is mainly dentoalveolar,
but skeletal effects on the vertical plane may also be
ªÂÙ¿ ÙÔ Ù¤ÏÔ˜ Ù˘ ¿ˆ ÌÂٷΛÓËÛ˘ ÙˆÓ ÁÔÌÊ›ˆÓ (∂ÈÎfi- achieved. The mild, continuous forces exercised by

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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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the two springs of the appliance achieve distal molar
movement without significant negative effects on the
anchorage unit. Following removal of the appliance,
maximum anchorage of first upper molars is necessary
during retraction of the canines and incisors for
treatment completion.
The Pendulum appliance is a reliable alternative in
clinical practice for distal movement of first maxillary
permanent molars.

REFERENCES

∂ÈÎfiÓ· 11. ™˘ÁÎÚ¿ÙËÛË ÙˆÓ ÁÔÌÊ›ˆÓ Ì ˘ÂÚÒÈÔ ÙfiÍÔ ÂÓÒ Á›ÓÂ- Bussick TJ, McNamara JA. Dentoalveolar and skeletal
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™. ™I¢HPO¶OY§OY Î·È Û˘Ó. H Û˘Û΢‹ Pendulum ÁÈ· ÙËÓ ¿ˆ ÌÂٷΛÓËÛË ÙˆÓ ÚÒÙˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ S. SIDIROPOULOU et al. The use of the Pendulum appliance for distal movement of first maxillary molars

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Î·È ‰ÈfiÚıˆÛË Ù˘ Û˘ÁÎÏÂÈÛȷ΋˜ ·ÓˆÌ·Ï›·˜ ∆¿Í˘ ππ, 1˘ molar distalization. J Clin Orthod 1992;26:402-
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ÙËÓ ÂÊ·ÚÌÔÁ‹ Ù˘ Û˘Û΢‹˜ Pendulum ÂÈÙ˘Á¯¿ÓÂÙ·È Û lightwire treatment. J Clin Orthod 1984;18:272-
Û‡ÓÙÔÌÔ ¯ÚÔÓÈÎfi ‰È¿ÛÙËÌ· ¯ˆÚ›˜ Ó· ÂÌÔ‰›˙ÂÙ·È ·fi 81.
ÙËÓ ‡·ÚÍË ÛÙÔÓ ÊÚ·ÁÌfi ÙˆÓ ‰Â‡ÙÂÚˆÓ ¿Óˆ ÁÔÌÊ›ˆÓ, ÔÈ Wong AMK, Rabie ABM, Hagg U. The use of
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Ù¢ÍË ÙÔ˘ ·ÔÙÂϤÛÌ·ÙÔ˜ ‰ÂÓ ··ÈÙÂ›Ù·È Ë ÂÓÂÚÁfi˜ malocclusion. Br Dent J 1999;187:367-70.
Û˘ÓÂÚÁ·Û›· ÙÔ˘ ·ÛıÂÓ‹.
∏ Â›‰Ú·ÛË Ù˘ Û˘Û΢‹˜ Â›Ó·È Î˘Ú›ˆ˜ Ô‰ÔÓÙÈ΋ ·ÏÏ¿
ÌÔÚ› Ó· ¤¯ÂÈ Î·È ÛÎÂÏÂÙÈο ·ÔÙÂϤÛÌ·Ù· ÛÙÔ Î·Ù·Îfi- Reprint requests to:
Ú˘ÊÔ Â›‰Ô. √È ÂÏ·ÊÚ¤˜ Î·È Û˘Ó¯›˜ ‰˘Ó¿ÌÂȘ Ô˘ Sosani Sidiropoulou
ÂÍ·ÛÎÔ‡ÓÙ·È ·fi Ù· ‰‡Ô ÂÏ·Ù‹ÚÈ· Ù˘ Û˘Û΢‹˜ ÂÈÙ˘Á- Assistant Professor
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‚·Ú‡ÓÔ˘Ó ÛËÌ·ÓÙÈο ÙËÓ ÛÙËÚÈÎÙÈ΋ ÌÔÓ¿‰·. ªÂÙ¿ ÙËÓ School of Dentistry
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΋˜ ıÂÚ·›·˜. ∏ Û˘Û΢‹ Pendulum ·ÔÙÂÏ› ¤Ó·
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E§§HNIKH OP£O¢ONTIKH E¶I£EøPH™H 2002 ñ TOMO™ 5 59 HELLENIC ORTHODONTIC REVIEW 2002 ñ VOLUME 5