Upper airways changes associated with orthodontic molar distalization by Pendulum appliance in adolescent patients: a multicenter retrospective cephalometric study

Abstract Objectives The purpose of this multicenter retrospective study was to perform a two-dimensional analysis of upper airway changes in adolescent patients following molar distalization with the Pendulum appliance. Materials and methods The study involved the cephalometric analysis of 88 patients, retrospectively categorized into two groups: skeletal Class II with a dental Class II molar relationship (36 patients, mean age 12.6 ± 1.1 years) and skeletal Class I with a dental Class II molar relationship (54 patients, mean age 12.3 ± 1.2 years). Changes were observed using lateral radiographs before (T0) and after Pendulum appliance removal (T1); treatment time averaged 7 months. Upper airways were subsequently analyzed by tracing lateral radiographs. The Shapiro-Wilk test showed a normal distribution of the data, therefore parametric tests were used for statistical analysis. Intragroup changes between T0 and T1 were evaluated using paired t-tests, and intergroup differences were assessed using independent student t-tests; statistical significance was set at 0.05. Results Statistically significant differences were observed in the skeletal measurements that characterized both groups, particularly in ANB and Wits appraisal, at T0 (P 0.05). Additionally, intergroup comparisons of airway changes at T1 did not show statistically significant differences (P > 0.05). Conclusions The Pendulum appliance does not significantly change the upper airway dimensions in Class I and Class II malocclusion patients, thereby minimizing potential respiratory risks.