Dentoskeletal Effects of Maxillary Protraction in Cleft Patients with Repetitive Weekly Protocol of Alternate Rapid Maxillary Expansions and Constrictions

Abstract

To evaluate the amount of maxillary protraction with face mask in complete unilateral cleft lip and palate patients submitted to two distinct rapid maxillary expansion (RME) protocols. The sample consisted of 20 individuals (nine boys and 11 girls; mean age of 10.4 +/- 2.62 years) with unilateral complete cleft lip and palate who had a constricted maxilla in the vertical and transverse dimensions. Ten patients underwent 1 week of RME with screw activation of one complete turn per day, followed by 23 weeks of maxillary protraction (group 1). The other 10 patients underwent 7 weeks of alternate rapid maxillary expansion and constriction, with one complete turn per day, followed by 17 weeks of maxillary protraction (group 2); both groups underwent a total of 6 months of treatment. Cephalometric measurements were taken at different times: pretreatment (T1), soon after RME (T2), and after 6 months of treatment (T3). Each measurement was analyzed with mixed models for repeated measures, and the covariance structure chosen was compound symmetry. The maxilla displaced slightly forward and downward with a counterclockwise rotation; the mandible rotated downward and backward, resulting in an increase in anterior facial height; the sagittal maxillomandibular relationship was improved; the maxillary molars and incisors were protruded and extruded; and the mandibular incisors were retroclined. There was no significant difference between the groups in evaluation time.