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Does Maxillary Protraction with Alt-RAMEC Protocol Affect Inferior Sclera Exposure? A Controlled 3dMD Study.

Yasemin Bahar Acar1, Hanife Nuray Yılmaz1, Elvan Önem Özbilen1

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|April 4, 2022
PubMed
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Maxillary protraction with alternate rapid maxillary expansions and constrictions (ARMC) followed by facemask treatment did not significantly alter inferior sclera exposure compared to controls. Both groups showed a decrease in the S:E ratio, indicating no differential effect of ARMC treatment.

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Area of Science:

  • Orthodontics
  • Craniofacial Development
  • Skeletal Malocclusions

Background:

  • Class III malocclusion often involves maxillary retrognathism.
  • Maxillary protraction is a common treatment modality.
  • Assessing soft tissue changes, like sclera exposure, is important for treatment outcomes.

Purpose of the Study:

  • To evaluate changes in inferior sclera exposure using 3D imaging.
  • To compare these changes in prepubertal Class III patients undergoing maxillary protraction with ARMC and facemask versus a control group.

Main Methods:

  • Retrospective study of 15 prepubertal Class III patients (ARMC + facemask) and 15 controls.
  • 3D stereophotogrammetric images and lateral cephalograms were analyzed pre- and post-treatment.
  • Inferior sclera exposure (S) and overall eye height (E) were measured to calculate the S:E ratio.

Main Results:

  • Both the treatment and control groups showed a significant decrease in the S:E ratio.
  • The Sella-Nasion-A point (SNA) angle changed significantly between groups.
  • No significant difference in the change of S:E ratio was found between the treatment and control groups.

Conclusions:

  • Alternate rapid maxillary expansions and constrictions (ARMC) followed by facemask treatment did not significantly alter inferior sclera exposure compared to natural changes in a control group.
  • The S:E ratio decreased in both groups, suggesting other factors may influence this measurement.
  • Further research is needed to understand the long-term soft tissue effects of maxillary protraction.