Ideally, the patient should have orthognathic profile; and it is not the modality of choice when there is significant dental protrusion and / or convexity of profile as intraoral distalizing appliances do not cause significant soft - tissue changes. On the contrary, certain appliances may cause mild increase in profile convexity. Therefore, the maxillary molar distalization therapy should be employed when the maxilla and mandible are skeletally normal with mild to moderate maxillary dental proclination or crowding. The patient should exhibit normal lower facial height as most distalizing appliances have an extrusive effect on the molars when they are distalized, leading to an increase in lower facial height.
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