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Skeletal and Dentoalveolar Effects Using Three Types of Maxillary Protraction Protocols
Da-In Kim1, Jae Hyun Park2,3, Mo-Hyeon Lee1
1Department of Orthodontics, College of Dentistry, Dankook University, Cheonan, Korea.
Introduction:
The purpose of this study is to compare the skeletal and dentoalveolar effects of the three types of facemask protocols in children.
Subjects And Methods:
Forty-eight subjects were grouped into three groups: bone-anchored facemasks (BAFMs) (BAFM group, n = 16, mean age 10.77 ± 1.00), facemask with miniscrew-assisted rapid palatal expanders (MARPEs) (MARPE/FM group, n = 16, mean age 10.47 ± 1.43) and facemask with rapid palatal expanders (RPEs) (RPE/FM group, n = 16, mean age 10.45 ± 1.04). Lateral cephalograms were taken at the initial observation (T0) and after maxillary protraction (T1). Cephalometric analysis was performed, and significance was assessed between the three groups. For statistical analysis, 1-way ANOVA or Kruskal-Wallis test was performed.
Results:
During maxillary protraction (T0-T1), greater maxilla advancement and greater intermaxillary relationship improvement were attained in BAFM (SNA: 2.28°, Mx. length: 3.13 mm, ANB: 3.41°, AB to MP: 5.31°) and MARPE/FM (SNA: 2.22°, Mx. length: 2.91 mm, ANB: 3.28°, AB to MP: 5.57°) groups than in the RPE/FM group (SNA: 1.09°, Mx. length: 1.46 mm, ANB: 2.08°, AB to MP: 2.77°) (p < 0.01). Protraction of the orbitale was greater in the BAFM (SNOr: 2.54°) group than in MARPE/FM (SNOr: 1.53°) and RPE/FM (SNOr: 1.28°) groups (p < 0.001). Also, the BAFM (PP to U6: 1.17 mm, U6 to VRmx: -1.18 mm) and MARPE/FM (PP to U6: 2.74 mm, U6 to VRmx: -2.80 mm) groups showed less maxillary first molar movement than the RPE/FM (PP to U6: 2.74 mm, U6 to VRmx: -2.80 mm) group. There was no significant difference in the mandibular variables and most of the vertical variables.
Conclusion:
The orthopaedic effects of BAFM and MARPE/FM were greater with maxillary protraction and intermaxillary relationship improvement than RPE/FM after protraction. Midface traction effects with MARPE/FM were less than with BAFM. However, MARPE/FM was more effective in preventing mesial movement and extrusion of the maxillary first molars.
