The aim of this study was to compare the effects of Class III correction appliances including the Facemask (FM), and the new non-compliance fixed functional appliances such as the Reversed Forsus Fatigue Resistant Device (FRD), as well as the CS-2000 (CS), on the sagittal pharyngeal airway dimension (SPAD). Pre-treatment and post-treatment lateral cephalograms of 45 patients who underwent Class III appliance treatment, using either FM, Reversed FRD, or CS were collected from the files of treated patients. SPAD changes were evaluated in each group, and comparisons were conducted between the three study groups. Additionally, sagittal and vertical skeletal measurements were conducted. The FM, the Reversed FRD, and the CS, were found to generate a significant increase in the SPAD, with the Reversed FRD contributing to the most significant change at the OPAA (116.80 ± 26.36 mm2). All three appliances elicited significant antero-posterior changes in the SNA°, SNB°, and ANB°, also with the greatest intermaxillary change documented with the employment of the Reversed FRD (ANB° = 3.33 ± 0.82°). As for the vertical dimension, the FM, the Reversed FRD, and the CS elicited significant FMA° increases, with the greatest change attributed to the FM (FMA° = 2.32 ± 0.97°). Therefore, the three tested Class III corrective appliances generated significant SPAD, antero-posterior, and vertical changes. However, the Revered FRD showed a superior impact in increasing the SPAD at the OPAA level and in eliciting significant intermaxillary changes.
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