Abstract
The aim of this study was to compare the efficacy of early treatment of Class III malocclusions with rapid maxillary expansion (RME) and facial mask (FM) versus the removable mandibular retractor (RMR) re-evaluated at a postpubertal observation on lateral cephalograms. All prepubertal patients with Class III malocclusion treated consecutively from 1986 to 2013 by means of RME/FM or RMR were analyzed. Twenty-nine patients treated with RME/FM therapy and 23 patients treated with RMR were selected. Lateral cephalograms were available at 3 time points, before treatment (T1), at the end of active treatment (T2), and at a postpubertal observation (T3). Statistical comparisons were performed with independent sample t tests or Mann–Whitney tests. During the T1–T3 interval, a significantly greater maxillary protraction (SNA +1.5 mm, p = 0.031) and significantly greater improvements in ANB and Wits appraisal (+1.9 degrees, p = 0.002, and +2.2 mm, p = 0.012, respectively) were recorded in the RME/FM group. No statistically significant changes could be found in vertical skeletal measurements. In the dentoalveolar region, the RME/FM group showed a significantly greater correction of the molar relationship (−1.5 mm, p = 0.021). Early treatment of Class III malocclusion with RME/FM protocol in comparison with RMR protocol showed a greater maxillary advancement and greater improvements in sagittal skeletal Class III relationships.
Highlights
Treatment of Class III malocclusion is one of the greatest challenges in contemporary orthodontics [1,2]
Different treatment approaches have been suggested for the early treatment of Class III malocclusion such as the facial mask [3,4], Frankel III Appliance [5], the
The short-term effects produced by rapid maxillary expansion (RME)/facial mask (FM) and removable mandibular retractor (RMR) have been described previously [1,2,3,4], limited information on the medium- to long-term stability is available [4]
Summary
Treatment of Class III malocclusion is one of the greatest challenges in contemporary orthodontics [1,2]. Saleh et al [13] in a randomized clinical trial reported that skeletal changes in mandibular shape in the treated group could be described as an “anterior morphogenetic rotation of the mandible” according to Lavergne and Gasson [15]. In the literature no data are available regarding the outcomes of RMR therapy re-evaluated at a postpubertal observation This information is essential for the evaluation of orthopedic treatment of patients with a Class III malocclusion, as a significant tendency to restore Class III dentoskeletal relationships after maxillary protraction has been demonstrated, especially after the pubertal growth peak [4]. Pubertal growth tends to last longer in Class III subjects compared with Class I subjects [16]
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