Mandibular Molar Distalization in Class III Malocclusion: A Systematic Review

Class III Malocclusion presents a complex orthodontic challenge with various treatment options, including orthodontic camouflage and orthognathic surgery. Among these, mandibular molar distalization stands as an orthodontic approach for treating Class III Malocclusion in adults. This systematic review aims to evaluate the current evidence regarding mandibular molar distalization techniques in the treatment of Class III. The search across PubMed, Scopus, Cochrane, and Web of Science databases yielded 582 articles, from which eight met the inclusion criteria. These inclusion criteria were as follows: English language, full text, studies randomized clinical trials, and retrospective studies that evaluated various methods of mandibular distalization for Class III Malocclusion in adult patients, from 2013 to May 2023. Lower molar distalization has gained attention as a non-surgical alternative with effective and efficient outcomes. However, various treatment modalities have limitations, including reliance upon malocclusion severity, diagnosis, patient cooperation, and operator experience. From the studies analyzed, it was found that techniques using skeletal anchorage with TADs, mini-plates, or ramal plates, offer stable anchorage and controlled tooth movement, they allow unilateral action in cases of asymmetry, and they are the most effective methods for achieving distal body displacement of the tooth. Despite the promising results, the relatively small number of studies calls for more high-quality research to explore the efficacy and outcomes of different mandibular molar distalization approaches. The lack of standardized protocols and guidelines for mandibular molar distalization in Class III Malocclusion is also attributed to the limited available literature.