Comparative evaluation of 2 skeletally anchored maxillary protraction protocols

Bone-anchored maxillary protraction in patients with unilateral cleft lip and palate:

“…This was confirmed by the increase in the effective maxillary length (Co-A), and by the increase in the linear distance between point A and the ISP representing the vertical reference plane (Table 4). However, other studies 7,20,21 have reported a greater amount of forward movement of point A using the BAMP protocol. This difference might be related to the stretching of the lip and palatal scar of patients with cleft that might have represented a restriction to the forward movement or might have been due to a longer investigation period in those studies.…”

“…The significant forward movement of the infraorbital and zygomatic regions in both groups was consistent with findings of other studies using BAMP. 7,12,21 These findings suggested that the effect of BAMP was limited not only to the maxilla but also extended superiorly to the level of the midface. This effect was evident clinically where the characteristic deficiency in the zygomatic region and the malar prominence, represented by the obvious paranasal concavity commonly seen in patients with cleft, 19 was greatly improved in the studied sample after treatment.…”

“…This difference might be related to the stretching of the lip and palatal scar of patients with cleft that might have represented a restriction to the forward movement or might have been due to a longer investigation period in those studies. Furthermore, measurements were taken on lateral cephalograms created from CBCTs with a 7.5% magnification factor in the studies carried out by De Clerck et al 7 and Cevidanes et al, 20 while Elnagar et al 21 used twodimensional lateral cephalometry, which reflected the changes of midline landmarks.…”

“…Since there was no statistically significant difference in the amount of maxillary protraction between the two groups, the hypothesis proposed by previous studies was confirmed. 7,8,[20][21][22][23][24][25] In those studies, maxillary expansion was not undertaken before the BAMP protocol because of the belief that the direct and continuous protraction force applied to the maxilla was enough to disarticulate the surrounding circummaxillary sutures. Therefore, expansion may be performed only when needed,but not for the purpose of enhancing the protraction protocol.…”

Displacement and stress distribution of the maxillofacial complex during maxillary protraction using palatal plates: A three-dimensional finite element analysis

“…Several studies have evaluated the effects of two different protocols of BAMP, comparing the facemasks with the zygomatic buttress miniplates versus the infrazygomatic miniplates and symphyseal miniplates connected with Class III elastics. These studies found that vertical changes and retroclination of the mandibular incisors were better controlled by Class III elastics from the infrazygomatic miniplates in the maxilla to the symphyseal miniplates in the mandible 29. Considering these results, the method of using the palatal plates and symphyseal miniplates with intraoral elastics may be worthwhile to explore as a viable alternative in the future.…”