Abstract
Abstract Background/aim To compare the outcomes of skeletally-anchored (SA) or face mask (FM) therapy in the management of patients presenting with maxillary retrognathia. Methods Forty-four consecutively treated maxillary retrognathic patients who underwent SA or FM therapies followed by fixed orthodontics were evaluated. Two micro-implants between the maxillary first molar and the second premolar and two mandibular miniplates were inserted to facilitate the use of Class III elastics in the SA group (23 patients). Facemasks with full occlusal-coverage acrylic appliances were applied in the FM group (21 patients). Lateral cephalometric radiographs obtained before treatment (T0), after orthopaedic treatment (T1), and after fixed orthodontic treatment (T2) were traced and 31 measurements compared. Results No statistically significant differences were found between the groups related to treatment duration and gender distribution. The mean age was significantly higher in the SA group (11.70±0.25 years) compared with the FM group (10.57±0.35 years) at T0. The mean ANB angle increased by 3.34° and 3.15° and the mean Wits value reduced by 6.16 mm and 4.13 mm in the FM and SA groups, respectively. Forward movement of the maxilla was similar between the groups. The vertical plane angle increased in both groups following maxillary protraction. However, it decreased in the SA group during fixed orthodontic therapy, which was contrary to what occurred in the FM group. The lower incisors were retracted/retroclined in the FM group and protracted/proclined in the SA group. Conclusions/implications Maxillary protraction was achieved in both groups and was maintained during fixed orthodontic therapy. Undesired lower incisor retraction and an increase of the vertical plane angle encountered with FM therapy were minimised by SA therapy.
Highlights
The protraction of the maxilla using a face mask (FM), coupled with the associated combined effects of dentoalveolar and skeletal changes in the management of Class III cases, have been identified in previous studies.[1,2,3,4] It is well known that particular dentoalveolarAustralasian Orthodontic Journal Volume 35 No 2 November 2019 and skeletal side effects are associated with FM treatment, since the force needed for skeletal alteration is applied through the roots of the teeth, generating dental changes
Patients exhibiting a functional Class III anomaly, and patients treated with a RME, the Alt-RAMEC protocol, ‘fun-type’ expanders, and Bone Anchored Maxillary Protraction (BAMP) method,[11] were excluded
Consecutive patients treated with SA and FM therapy followed by fixed orthodontics were evaluated and compared
Summary
The protraction of the maxilla using a face mask (FM), coupled with the associated combined effects of dentoalveolar and skeletal changes in the management of Class III cases, have been identified in previous studies.[1,2,3,4] It is well known that particular dentoalveolar. Australasian Orthodontic Journal Volume 35 No 2 November 2019 and skeletal side effects are associated with FM treatment, since the force needed for skeletal alteration is applied through the roots of the teeth, generating dental changes. Clinicians have increasingly applied skeletal anchorage for maxillary protraction to avoid the side effects associated with tooth-borne devices.[7,8,9,10,11,12,13] Various mechanisms have been introduced to enhance maxillary projection by applying direct forces to the skeletal structures. Titanium miniplates have been used along with FMs for generating purely boneborne orthopaedic forces.[9,10] The maxillary protraction methods necessitate extra-oral forces and require 12hour daily use, which can lead to difficulties related to patient compliance
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