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. 2022 Sep 30;23(1):44.
doi: 10.1186/s40510-022-00429-0.

Long-term skeletal and dentoalveolar effects of hybrid rapid maxillary expansion and facemask treatment in growing skeletal Class III patients: a retrospective follow-up study

Giuliano B Maino  1 , Francesca Cremonini  2 , Giovanna Maino  1 , Emanuele Paoletto  3 , Matteo De Maio  4 , Giorgio Alfredo Spedicato  5 , Mario Palone  1 , Luca Lombardo  1
Affiliations

Long-term skeletal and dentoalveolar effects of hybrid rapid maxillary expansion and facemask treatment in growing skeletal Class III patients: a retrospective follow-up study

Giuliano B Maino et al. Prog Orthod. .

Abstract

Background: Regardless of the treatment protocol, stability in Class III patients always represents a major concern. The aim of this study was to assess the short and long-term skeletal and dentoalveolar modifications in a group of class III patients treated with hybrid rapid maxillary expander (RME) and facemask (FM). Indeed, no long-term studies have been conducted yet with the objective of evaluating the effects of this kind of approach when applied to patients who have already gone thought their peak of growth.

Material and methods: 27 patients with skeletal Class III malocclusion were treated using hybrid RME according to alternating rapid maxillary expansion and constriction (ALT-RAMEC) protocol, followed by 4 months of facemask therapy. After the orthopaedic phase, each patient underwent orthodontic treatment with fixed multibracket appliances. A mean follow-up of 7 years, 10 months was performed. Pre-treatment (TO), post-treatment (T1) and follow up (T2) cephalometric tracing were analysed, comparing dental and skeletal measurements.

Results: Point A advanced by a mean of 3.5 mm with respect to VerT, then relapsed by 0.7 in the post-facemask period, thereby yielding of a mean advancement of 2.7 at T2. The sagittal relationship significantly changed after RME + facemask protraction (3.8° of ANB and 5.189 mm of Wits). Although both Wits and ANB values worsened over time, the improvement from T0 is still appreciable at T2.

Conclusion: Despite the physiological relapse due to mandibular growth, the long-term cephalometric follow-up confirms the maintenance of all positive outcomes of the previous orthopaedic treatment with hybrid RME and facemask.

Keywords: Class III malocclusion; Facemask; Miniscrews; Palatal anchorage; Skeletal expansion.

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Conflict of interest statement

The authors declare that they have no competing interests in this section.

Figures

Fig. 1
Fig. 1
a, b Planning of miniscrews insertion on CBCT
Fig. 2
Fig. 2
a, b SKAR III orthodontic device
Fig. 3
Fig. 3
a–c Profile photographs of one patient of the study group at T0, T1, and T2
Fig. 4
Fig. 4
a–c Lateral occlusal photographs of one patient of the study group at T0, T1, and T2
Fig. 5
Fig. 5
a–c Lateral X-rays of one patient of the study group at T0, T1, and T2
See this image and copyright information in PMC

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References

    1. Baccetti T, Franchi L, McNamara JJ. Growth in the untreated Class III subjects. Semin Orthod. 2007;13:130–142. doi: 10.1053/j.sodo.2007.05.006. - DOI
    1. Cordasco G, Matarese G, Rustico L, Fastuca S, Caprioglio A, Lindauer S, Nucera R. Effiacy of orthopedic treatment with protraction facemask on skeletal Class IIi malocclusion: a systematic review and meta-analysis. Orthod Craniofac Res. 2014;17:133–143. doi: 10.1111/ocr.12040. - DOI - PubMed
    1. Woon SC, Thiruvenkatachari B. Early orthodontic treatment for Class III malocclusion: a systematic review and meta-analysis. Am J Orthod Dentofac Orthop. 2017;151:28–52. doi: 10.1016/j.ajodo.2016.07.017. - DOI - PubMed
    1. Wells A, Sarver D, Proffit W. Long-term efficacy of reverse pull headgear therapy. Angle Orthod. 2006;76:915–922. doi: 10.2319/091605-328. - DOI - PubMed
    1. Inoue Y, Hartsfield JK, Jr, Tome W, Kitai N. Analysis of pretreatment factors associated with stability in early Class III treatment. Prog Orthod. 2021;22:23. doi: 10.1186/s40510-021-00371-7. - DOI - PMC - PubMed

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