The Blondex Palatal TAD-Supported Distalizer: A Technical Report of Three Independent Clinical Cases Using Analog, Mixed, and Fully Digital Workflows

Background: Maxillary molar distalization is frequently used for Class II correction, but conventional appliances may be associated with compliance requirements and unwanted dental side effects. Skeletal anchorage can improve anchorage control and facilitate more targeted posterior tooth movement. Aim: To describe the design, biomechanical rationale, and clinical application of the Blondex palatal TAD-supported distalizer through three illustrative clinical cases managed via different clinical and laboratory workflows. Detailed case description: Three patients requiring maxillary molar distalization were treated with the Blondex appliance supported by two palatal miniscrews. The cases illustrate an analog workflow based on conventional impressions and freehand miniscrew placement, a mixed workflow using digital diagnostic planning with hybrid laboratory procedures, and a fully digital “one-visit” workflow integrating CBCT, intraoral scans, CAD/CAM surgical guidance, miniscrew placement, and appliance delivery. In all three cases, the appliance was used to establish Class I molar and canine relationships while incorporating control over molar derotation, distalization, and, where indicated, vertical movement. Because of the descriptive design and the heterogeneity of the cases, no pooled estimate of distalization rate or treatment effect was calculated. Conclusions: This three-case series illustrates the clinical versatility of the Blondex appliance and its compatibility with analog, mixed, and fully digital workflows. The appliance may be considered in selected patients requiring TAD-supported maxillary molar distalization, but its comparative effectiveness, skeletal and dental side effects, and long-term stability require evaluation in larger controlled studies.