Skeletal Anchorage for Orthopedic Correction of Growing Class III Patients

Abstract

Maxillary protraction headgear in conjunction with expansion appliances have been widely used in the treatment of Class III malocclusion with maxillary deficiency. However, there are problems associated with protracting the maxilla with conventional tooth-borne anchorage. These include the loss of dental anchorage, which is of concern, especially in situations in which preservation of arch length is necessary. In addition, tooth borne anchorage alone does not allow the application of orthopedic force directly to the maxillary sutures. The latter effects can be eliminated or minimized by the use of absolute intraoral anchorage devices, such as miniplates. Several reports have been published in the literature on the use of miniplates for maxillary protraction. However, the skeletal and dental changes in response to maxillary protraction using miniplates as anchorage have not been reported. The purpose of the present study was to quantify and compare the effects of maxillary protraction when using a facemask in conjunction with a rapid maxillary expansion appliance (RME) with a second group treated with a facemask together with a surgical miniplate as anchorage. Maxillary protraction headgear in conjunction with expansion appliances have been widely used in the treatment of Class III malocclusion with maxillary deficiency. However, there are problems associated with protracting the maxilla with conventional tooth-borne anchorage. These include the loss of dental anchorage, which is of concern, especially in situations in which preservation of arch length is necessary. In addition, tooth borne anchorage alone does not allow the application of orthopedic force directly to the maxillary sutures. The latter effects can be eliminated or minimized by the use of absolute intraoral anchorage devices, such as miniplates. Several reports have been published in the literature on the use of miniplates for maxillary protraction. However, the skeletal and dental changes in response to maxillary protraction using miniplates as anchorage have not been reported. The purpose of the present study was to quantify and compare the effects of maxillary protraction when using a facemask in conjunction with a rapid maxillary expansion appliance (RME) with a second group treated with a facemask together with a surgical miniplate as anchorage.