## 6 Discussion  
Class II malocclusions can be subdivided into skeletal and dental subtypes. In skeletal Class II malocclusion, orthopedic and orthodontic corrections are typically pursued before growth and development are complete, while surgical approaches or camouflage treatments may be considered, depending on the severity of the malocclusion after growth has ceased [71; 72]. In cases of dental Class II malocclusion, where no skeletal discrepancy is present, orthodontic correction is required to address the malocclusion. One of these corrective methods involves the distalization of the upper molars. In orthodontics, the distalization of the upper molars is primarily achieved through extraoral and intraoral methods. Extraoral appliances such as headgear have been utilized in orthodontic practice for many years and have demonstrated effective results. However, in contemporary settings, the acceptability of extraoral appliances has declined due to aesthetic concerns [24]. One study reported complications associated with headgear use, including skin irritation, abnormal tension in neck muscles, and injuries to the face and eyes [73]. Beyond aesthetic concerns, these appliances rely on patient compliance, which can negatively impact treatment effectiveness from a clinician's perspective. Consequently, challenges such as patient cooperation, associated complications, and difficulty in achieving a Class I molar relationship as patients age have led researchers to develop intraoral distalization methods [74]. Unlike headgear, these systems do not require extraoral support for distalization; rather, they apply continuous force while relying on adjacent teeth and tissues for support. As a result, anchorage loss in premolars and incisors is common. Furthermore, when the mesially shifted premolars and incisors are subsequently distalized, additional disadvantages, such as anchorage loss and time inefficiency, may arise [75]. To ensure the permanence of results and prevent relapse after molar distalization, it is recommended that molars not be used as support for any orthodontic movement for at least 4-5 months following the completion of distalization. Given these requirements, intraoral molar distalization methods, which allow for rapid distalization, may actually prolong the overall treatment duration when the necessary retention period is considered [75]. Consequently, when tooth tissue-supported appliances are used, treatment duration may increase, and anchorage loss may develop in the supporting teeth. To address this anchorage loss, researchers have sought to utilize direct bone support. Initially, osseometgrated implants were employed [76], but their primary drawbacks include the need for surgical placement and removal, an average postoperative healing period of three months, and relatively large size [77]. Another technique for providing direct skeletal anchorage is the use of titanium mini-plates, which, despite requiring surgical placement and having limited application sites, offer the significant advantages of eliminating the need for osseointegration and allowing the application of heavy forces [78]. In recent years, miniscrews have become increasingly popular, as they help overcome the disadvantages of surgical stages and osseointegration requirements [79]. In addition to their small size, which enables their use for distalization in the oral cavity, skeletal anchorage distalization mechanics are frequently noted in the literature to have minimal complications [48; 51]. Due to these advantages, the use of orthodontic miniscrews has become widespread, and miniscrew-supported molar distalization methods have gained popularity as a means of minimizing anchorage loss. The primary advantage of miniscrew-supported molar distalization is that it does not require other dental structures to serve as anchorage units.