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Randomized Controlled Trial
. 2020 Jan;90(1):3-12.
doi: 10.2319/101718-750.1. Epub 2019 Aug 12.

A comparative assessment of orthodontic treatment outcomes of mild skeletal Class III malocclusion between facemask and facemask in combination with a miniscrew for anchorage in growing patients: A single-center, prospective randomized controlled trial

Masahiro Seiryu, Hiroto Ida, Atsushi Mayama, Satoshi Sasaki, Shutaro Sasaki, Toru Deguchi, Teruko Takano-Yamamoto
Randomized Controlled Trial

A comparative assessment of orthodontic treatment outcomes of mild skeletal Class III malocclusion between facemask and facemask in combination with a miniscrew for anchorage in growing patients: A single-center, prospective randomized controlled trial

Masahiro Seiryu et al. Angle Orthod. 2020 Jan.

Abstract

Objectives: To investigate the hypothesis that there is difference in the treatment outcomes of milder skeletal Class III malocclusion between facemask and facemask in combination with a miniscrew in growing patients.

Materials and methods: Patients were randomly divided into two groups. In one group, the patients were treated with facemask therapy (FM group: 12 males, eight females, average age: 10 years, 5 months ± 1 year, 8 months). In the other group, patients were treated with facemask therapy along with a miniscrew (FM+MS group: 12 males, seven females, average age: 11 years, 1 month ± 1 year, 3 months). A lingual arch with hooks was fixed to the maxillary arch in both groups and a protractive force of 500 g was applied from the facemask to the hooks. The patients were instructed to use the facemask for 12 hours per day. In the FM+MS group, a miniscrew was inserted into the palate and fixed to the lingual arch.

Results: Mobility and loosening of the miniscrew were not observed during treatment. Lateral cephalometric analysis showed that SNA, SN-ANS, and ANB values were significantly increased in the FM+MS group compared with those for the FM group (SNA, 1.1° SN-ANS, 1.3° ANB, 0.8°). Increase in proclination of maxillary incisors was significantly greater in the FM group than in the FM+MS group (U1-SN, 5.0°).

Conclusions: During treatment of milder skeletal Class III malocclusion, facemask therapy along with a miniscrew exhibits fewer negative side effects and delivers orthopedic forces more efficiently to the maxillary complex than facemask therapy alone.

Keywords: Absolute anchorage; Class III malocclusion; Facemask therapy; Maxillary protraction; Miniscrew.

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Figures

Figure 1.
Figure 1.
CONSORT flowchart.
Figure 2.
Figure 2.
Intra- and extraoral appliances of the FM group. (A) Facemask; (B) Lingual arch with soldered hooks (front view); (C) Lingual arch with soldered hooks (occlusal surface view); (D) lateral view (arrow shows direction of maxillary traction); (E) occlusal surface view. FM indicates facemask.
Figure 3.
Figure 3.
Intra- and extraoral appliances of the FM+MS group. (A) facemask; (B) lingual arch with soldered hooks (front view); (C) lingual arch with soldered hooks (occlusal surface view; arrow shows a miniscrew); (D) lateral view (arrow shows direction of maxillary traction); (E) occlusal surface view (arrow shows a miniscrew).
Figure 4.
Figure 4.
Direction of elastic force application.
Figure 5.
Figure 5.
Cone-beam computed tomography scans after miniscrew implantation. (A) coronal view; (B) Sagittal view; (C) Axial view. (For all panels, arrows show miniscrews.)
Figure 6.
Figure 6.
Landmarks and planes used in cephalometric analyses in this study.
See this image and copyright information in PMC

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