Comparison of skeletal anchorage and tooth-borne maxillary protraction followed by fixed appliance in Class III malocclusion

Abstract

Summary Objectives The purpose of this study was to compare the results of skeletal anchorage (SAMP) and tooth- borne (TBMP) maxillary protraction followed by fixed appliance in growing skeletal Class III patients. Materials and methods Patients treated with maxillary protraction were selected and classified into two groups (SAMP: n = 19, mean age = 11.19 years; TBMP: n = 27, mean age = 11.21 years). Lateral cephalograms taken before treatment (T0), after the maxillary protraction (T1), and after the fixed appliance treatment (T2) were analysed and all variables were statistically tested to find difference between the two groups. Results Compared to the TBMP, the SAMP showed significant forward growth of maxilla (Co-A point and SN-Orbitale) and improvement in intermaxillary relationship (ANB, AB to mandible plane, and APDI) after the overall treatment (T0–T2), with no significant sagittal changes in maxilla or mandible throughout the fixed appliance treatment (T1–T2). Limitations In maxillary protraction, effects of skeletal anchorage were retrospectively compared with those of dental anchorage, not with Class I or III control. Conclusions and implications After maxillary protraction, skeletal and tooth-borne anchorage did not cause significant differences in the residual growth of maxilla throughout the phase II treatment. Orthopaedic effects with skeletal anchorage showed appropriate stability in maxilla and intermaxillary relationship even after fixed appliance treatment.

Comparison of treatment effects of different maxillary protraction methods in skeletal class III patients

“…In parallel with the findings of the literature, 2,33‐39 an increase in dentoalveolar parameters, protrusion in the upper incisors, retrusion in the lower incisors and, accordingly, an increase in overjet was observed in all three groups. Although there was no direct support from the upper incisors in all the groups, protrusion occurred in the upper incisors as a result of mesialization of the upper teeth from the protraction force in the RME and modified Alt‐RAMEC groups, which received support from the posterior teeth.…”

“…Sar et al reported a 1.63° counterclockwise rotation in the maxilla with a conventional face mask and a 0.92° rotation from the miniplates in the facemask group 23 . Lee et al reported a 0.54° counterclockwise rotation in the maxilla with a conventional face mask, and a 0.73° rotation from the miniplates in the facemask group 36 . While the most rotation among the three groups in our study was in the RME group (−2.69°), the least rotation was found in the skeletal anchorage group (−0.31°).…”

“…As a result of the forward movement of the maxilla, point A is different in the three different methods, though it was not statistically significant. In studies comparing the effects of the face mask after RME with Alt-RAMEC, it has been reported that with the application of Alt-RAMEC (average of 3.04-5.82 mm) is approximately two 23,24,36 In our study, at least (2.67 mm) in the RME and modified Alt-RAMEC groups, a forward movement with a maximum of 4.01 mm was observed in the maxilla. Although our findings are consistent with the literature, in the previous studies, in the modified Alt-RAMEC group, more forward movement was observed in RME, while in skeletal anchorage applications, more forward motion was observed than in RME.…”

“…23 Lee et al reported a 0.54° counterclockwise rotation in the maxilla with a conventional face mask, and a 0.73° rotation from the miniplates in the facemask group. 36 While the most rotation among the three groups in our study was in the RME group (−2.69°), the least rotation was found in the skeletal anchorage group (−0.31°).…”

“…In studies comparing the effects of the face mask after RME with Alt‐RAMEC, it has been reported that with the application of Alt‐RAMEC (average of 3.04‐5.82 mm) is approximately two times more effective than RME (average 1.92‐2.74 mm) 2 . In skeletal anchorage–supported maxillary protraction applications in the literature, the amount of protraction varies between 2.83 mm and 4 mm 23,24,36 . In our study, at least (2.67 mm) in the RME and modified Alt‐RAMEC groups, a forward movement with a maximum of 4.01 mm was observed in the maxilla.…”