Editor's Note: Previous articles on the Pendulum/Pendex TM appliance can be found in Issue1

Movement of any tooth in any direction with the proper application of pressure has long been a tenet or principle of Bioprogressive Therapy. Some clinicians have steadfastly maintained that it is impossible to move upper molars distally more than 1 or 2mm. Contrary to this opinion, newer, more predictable methods of force application to the upper molars have proven that in many cases the ability to move the upper molars distally is virtually unlimited. Whether that is always desirable is another question, but the mechanical applications to do so are no longer in doubt. It is the purpose of this article to further explore one of these distalizing techniques and to discuss the sequelae of its use.

The Pendulum or Pendex Appliance that was described in the first part of this article was designed by Dr. James Hilgers to use the inherent anchorage provided by the palate and, to some extent, the upper buccal segment teeth, to distalize, expand and rotate the upper molars without unduly disturbing the lower arch.

It became very clear at the outset that moving the upper molars back was not the difficult part of this form of appliance therapy it was, in fact, very dynamic and predictable. Holding them back during retraction of the rest of the maxillary teeth has been a more challenging task, however. It makes absolutely no sense to simply round-trip the molars with little or no Class II correction. The techniques described herein define the authors’ experience with molar stabilization to date.

There are basically 13 techniques that can be used singly or in concert to posi-tion the upper molar in its proper loca-tion. Each will be discussed and demonstrated separately. They are:

1. Overcorrection
2. Quick-Nance (Hilgers)
3. Short term headgear
4. Stops on archwires
5. Upper utility arch
6. Push coil spring at cuspids
7. Early bonding in the upper arch
8. Class II elastics
9. Upper lip bumper
10. Hawley or clear-type retainers
11. Bionator
12. Short-haul Herbst appliance
13. Long-haul Herbst appliance

Overcorrection

Quick-Nance

Short-term headgear

Stops on archwires

Upper utility arch

Push coil springs at cuspid region

Early bonding of the upper arch

Class II elastics

Upper lip bumper

Clear (slipcover) or Hawley-type retainers

Bionator

Short-haul Herbst appliance

Long-haul Herbst appliance

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