Cephalometric effects of Pushing Splints 3 compared with rapid maxillary expansion and facemask therapy in Class III malocclusion children: a randomized controlled trial

Abstract

Summary Background Pushing Splints 3 (PS3) device was recently introduced for the treatment of Class III malocclusion in children. Objectives To assess the effect on the sagittal maxillary position (SNA, primary outcome) of PS3 therapy compared with rapid maxillary expansion and facemask therapy (RME/FM) and to compare skeletal and dento-alveolar effects in growing Class III patients. Trial design This trial was a single-centre randomized controlled trial with two groups randomly allocated in a 1:1 ratio of equal size by sealed-envelope randomization, conducted at the Dentistry Unit of Bambino Gesù Children’s Hospital, IRCCS (Rome, Italy). Methods A total of 48 patients with Class III malocclusion were included in the study and randomly allocated to the two groups: PS3 therapy and RME/FM therapy. Only the RME/FM group underwent palatal expansion, and both groups were instructed to wear the appliances 14 hours/day. Pre- (T0) and post-treatment (T1) cephalograms were taken. An independent sample t-test and regression analysis were used to analyse the data (P value <0.05). Researchers involved in statistics and tracings were blinded to the treatment allocation. Results A total of 42 patients (21 for each group) completed the study. The maxillary sagittal position improved similarly in both groups (SNA = 0.4°; P = 0.547). A statistically significant decrease of SNPg angle (−1.6°; P < 0.001) and increase of ANPg angle (1.4°; P = 0.018) were found in the RME/FM group compared with PS3 group. CoGoMe angle significantly decreased in RME/FM group compared with PS3 group (−1.7°; P = 0.042). The regression analysis showed an association between SN/MP angle at T0 and the differences between T1 and T0 of SNPg (B = 0.13; P = 0.005) and SN/MP (B = −0.19; P = 0.034). Only three patients (PS3 = 2; RME/FM = 1) had breakages of the devices. Limitations Results are limited to short-term effects. Conclusion RME/FM therapy and PS3 are both effective therapies for the early correction of Class III malocclusion. The PS3 controlled better mandibular divergency reducing the clockwise rotation in patients with higher mandibular inclination. Registration This study was not registered in a clinical trial registry.

Postpubertal Effects of the Rapid Maxillary Expansion and Facial Mask versus the Removable Mandibular Retractor for the Early Treatment of Class III Malocclusion: A Study on Lateral Cephalograms

“…Class III malocclusion in growing children is one of the most challenging malocclusions to treat. The most common treatment protocols for Class III malocclusion include RME/FM therapy, function regulator, chin cup, and other approaches [1,2,5,7,20,21]. RME/FM therapy is the most common orthopedic treatment protocol for Class III malocclusion [1][2][3][4].…”

Clear Aligners Treatment of Class III Subdivision with an Extraction of a Lower Bicuspid

“…If the patient is of a pre-pubertal age and in early mixed dentition, the aim of Class III treatment is to try re-establishing the normal skeletal growth pattern and improving the occlusal relationship [ 2 ]. The most utilized approaches in growing patients are represented by orthopedic therapy with a rapid maxillary expansion and facemask or with other functional appliances [ 3 , 4 ]. When the patient passes the growth peak, dental compensation without correction of the skeletal malocclusion becomes the only possible strategy, or alternatively, if the skeletal discrepancy is too great, it is necessary to wait until the end of growth and seek orthognathic surgery [ 5 ].…”

Soft-Tissue Changes in Unilateral Cleft Lip and Palate Patients after Non-surgical Maxillary Advancement with Face Mask Therapy - A Prospective Cohort Study

“…[ 3 4 ] Face mask therapy has been commonly used for maxillary advancement along with rapid maxillary expansion (RME). [ 5 6 7 ]…”