Abstract
BackgroundThe use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients. The aim of this study was to evaluate the treatment of class III patients with maxillary retrusion, using orthodontic mini-implants (MI) associated with intermaxillary elastics in comparison with the rapid maxillary expansion and facemask protocol (RME/FM).MethodsIn this prospective non-randomized clinical trial, the sample of 24 participants between 7 and 12 years of age (median age of 10.0 years and interquartile range = 3.0 years), at the stage prior to the pre-pubertal growth spurt, was divided in two groups. In group facemask (FM) (n = 12), the individuals received orthopedic treatment with RME/FM. In group MI (n = 12), two mini-implants were inserted in the region close to the maxillary first molar roots, and the other two in the region of the mandibular canines. Initial and final lateral teleradiographs were taken for cephalometric evaluation of all the cases. Statistical analysis included the Mann-Whitney, Wilcoxon, and Fisher’s exact tests. The level of significance was 5% (α = 0.05).ResultsImprovement was verified in the facial profile and occlusion of the participants, showing advancement of the maxilla in the two groups, with significant differences (P ≤ 0.05) between T0 and T1 in the following measurements: SNA, ANB, Wits, Co-A, Co-Gn, NAP, A-Npog, overjet, and molar relationship. There was no statistically significant intergroup difference (P > 0.05) in the cephalometric measurements evaluated, but the time of treatment was significant, and was faster for group MI.ConclusionsThe protocol with mini-implants may be an option for the correction of Class III due to maxillary deficiency.
Highlights
The use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients
The aim of this study was to test whether conventional orthodontic mini-implants inserted in the maxilla and mandible, associated with intermaxillary elastics would serve as anchorage for protracting the maxilla in class III patients with deficiency of the middle third of the face, and compare the results with those of patients treated with rapid maxillary expansion and facemask
Analysis of the cephalometric measurements in groups FM and MI in Baseline or initial time (T0) showed no significant differences between the groups, indicating that the two groups presented similar clinical characteristics at baseline of the study (Table 1)
Summary
The use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients. Over the course of several decades, patients with class III malocclusion due to deficiency of the middle third of the face, at the stage of growth, have been treated by means of maxillary protraction with a facemask presenting satisfactory results [1,2,3,4,5,6,7,8,9,10,11,12], when the patient cooperates with the use of the extra oral appliance [13, 14]. The authors confirmed that general sedation was the preferred option in cases in which four miniplates were scheduled for placement in children for the purpose of orthopedic traction [19]
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