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The maxillary sagittal appliance: a clinical study.

A H Owen

    American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics
    |April 1, 1987
    PubMed
    Summary

    The maxillary sagittal appliance advances incisors and increases arch length but does not significantly distalize molars. Caution is advised for long-faced patients due to increased lower anterior facial height.

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    Area of Science:

    • Dentistry
    • Orthodontics
    • Craniofacial Biology

    Background:

    • The maxillary sagittal appliance is an active plate device designed for anteroposterior expansion.
    • Its primary proposed functions include maxillary incisor advancement and molar distalization to increase arch length.

    Observation:

    • A clinical review assessed the efficacy of the maxillary sagittal appliance in orthodontic treatment.
    • Measurements included incisor advancement, molar position, A point changes, and upper lip posture.
    • Mandibular changes and lower anterior facial height were also evaluated over an average treatment period of 7.4 months.

    Findings:

    • Maxillary incisors were advanced approximately 2 mm with an 8-degree increase in inclination.
    • Maxillary molars did not demonstrate significant distalization, potentially due to the absence of second molar extractions.

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  • A point showed minor advancement, and the upper lip advanced by 1.4 mm.
  • Mandibular length increased by 3.00 mm, and lower anterior facial height increased by 2.85 mm, suggesting potential contraindication in long-faced patients.

    • Implications:

    • The appliance is clinically manageable and useful for pre-treatment decompensation of maxillary teeth.
    • It can be considered for Class II, Division 1 or Class II, Division 2 patients with specific lip profiles before functional jaw orthopedic or fixed therapy.
    • The observed increase in lower anterior facial height warrants careful consideration in patient selection, particularly those with dolichofacial patterns.