The Effects of Maxillary Protraction with or without Rapid Maxillary Expansion and Age Factors in Treating Class III Malocclusion: A Meta-Analysis

Abstract

We conducted a comprehensive meta-analysis of 12 studies to examine whether maxillary protraction face mask associated with rapid maxillary expansion (FM/RME) could be an effective treatment for Class III malocclusion and to evaluate the effect of timing on treatment response. Patients with a maxillary deficiency who were treated with FM with or without RME were compared with those who had an untreated Class III malocclusion. In both treatment groups, forward displacement of the maxilla and skeletal changes were found to be statistically significant. In addition, posterior rotation of the mandible and increased facial height were more evident in the FM group compared with the control group. However, no significant differences were observed between the early treatment groups and late treatment groups. The results indicated that both FM/RME and FM therapy produced favorable skeletal changes for correcting anterior crossbite, and the curative time was not affected by the presence of deciduous teeth, early mixed dentition or late mixed dentition in the patient.

Skeletal and dental effects of Class III orthopaedic treatment: a systematic review and meta‐analysis

“…Class III orthopaedic therapy includes several appliances, not always assessed by RCTs . Other systematic reviews comprised randomised and non‐randomised studies without evaluating if the study design could affect the results . Indeed, an interesting finding of this review was that some results may be overestimated due to the study design.…”

“…Six systematic reviews and meta‐analysis have recently been published on skeletal Class III malocclusion treatment , only focusing on RCTs or a single appliance.…”

Effect of face mask therapy on mandibular rotation considering initial and final vertical growth pattern: A longitudinal study

“…The skeletal Class III relationship is produced by alterations in size or position of the maxilla and jaw, presenting as retrusion or hypoplasia of the maxilla in the presence of normal jaw, as prognathism or macrognathism with normal maxilla, or as an alteration of the position and size of both jaws, involving sagittal, transversal, and vertical disharmonies (Toffol, Pavoni, Baccetti, Franchi, & Cozza, ; Zhang, Qu, Yu, & Zhang, ). Incidence of Class III malocclusion varies among populations, ranging from 1% to 5% in Whites, 5% in Latinos, and from 9% to 19% in Asians (Haynes, ; Thilander, ; Toffol et al, ).…”

“…Wolfe et al reported that, compared with a Class I control group, patients with Class III malocclusion display hyperdivergent jaws and increased inferior facial height (Wolfe, Araujo, Behrents, & Buschang, ). Treatment has been aimed at maxillary advancement and/or control of jaw growth, and several devices have been designed for this purpose such as protraction face masks (FMs), chincups, mandibular cervical hedgear, and functional orthopedic appliances (Baccetti, Rey, Angel, Oberti, & McNamara, ; Baccetti, Rey, Oberti, Stahl, & McNamara, ; Baik, Jee, Lee, & Oh, ; Rey, Angel, Oberti, & Baccetti, ; Zhang et al, ).…”

“…This type of skeletal relationship represents one of the most challenging issues faced by the orthodontic clinician due to the unpredictable and potentially unfavorable vertical growth pattern that these patients may exhibit (Kim, Viana, Graber, Omerza, & BeGole, 1999;Zhang et al, 2015). Wolfe et al reported that, com-pared with a Class I control group, patients with Class III malocclusion display hyperdivergent jaws and increased inferior facial height (Wolfe, Araujo, Behrents, & Buschang, 2011).…”