Clear Aligners vs Fixed Appliances for Molar Distalization Using Infrazygomatic Crest Screws

This study compares three different methods of moving upper back teeth backward (distalization) to create space for crowded or protruding teeth, all supported by small temporary screws placed in the cheekbone area (infrazygomatic crest screws). Participants were randomly assigned to one of three treatment types: traditional fixed braces (Pitts21 system), Invisalign clear aligners, or ClearCorrect clear aligners. The study measures how effectively each method moves the back teeth, how long treatment takes, and how comfortable and practical each method is for patients. The goal is to help orthodontists and patients choose the most effective and efficient treatment option for this type of tooth movement.

Inclusion Criteria: * Skeletal Class I (ANB angle 0-4°), dental Class II malocclusion treatable with molar distalization * Need for unilateral or bilateral distalization of the first molars in the range of 2-4.5 mm * Chronological age between 13 and 18 years, regardless of skeletal age * Normal or hypodivergent growth pattern (SN-GoGn \< 39°) * Mild to moderate maxillary crowding (less than 6 mm) and minimal or no mandibular crowding (less than 3 mm) * No previously extracted maxillary teeth, excluding third molars * Erupted permanent second molars * Good oral hygiene * Healthy periodontal tissues Exclusion Criteria: * Need for orthodontic tooth extraction or functional appliance therapy * Presence of systemic disease * Congenital or acquired craniofacial deformity involving the condyle or mandible * Poor patient cooperation * History of allergy to any metal * Pre-existing root resorption prior to treatment * Previous orthodontic treatment * Abnormal position, depth of impaction, or close proximity to adjacent anatomical structures (sinus, neurovascular structures) of the maxillary third molar that would make its surgical extraction risky