Three-dimensional assessment of soft tissue changes associated with bone-anchored maxillary protraction protocols

Elnagar, Mohammed H.; Elshourbagy, Eman; Ghobashy, Safaa; Khedr, Mohamed; Kusnoto, Budi; Evans, Carla A.

doi:10.1016/j.ajodo.2017.01.022

Cited by 24 publications

(21 citation statements)

References 40 publications

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“…All the results obtained in the present research using mini-implants, as well as other findings that showed the elastics adapted between maxillary and mandibular miniplates, had an inclination of approximately 45° in relation to the occlusal plane [33]. The elastics adapted to the hooks of the miniplates in the patients treated with facemask had an inclination of around 15° to 20° with the occlusal plane.…”

Section: Discussionsupporting

confidence: 76%

“…The force used in group MI, generated by the medium ¼′′ intermaxillary elastics, as from the second month, was 200 g on an average, and as in the studies with miniplates [10, 12, 14–18, 33], it was also localized below the center of resistance of the maxilla, but the anti-clockwise rotation of the palatine plane was discrete, without affecting the facial pattern of the patients. The different position of the mandibular mini-implants in group MI (Fig.…”

Section: Discussionmentioning

confidence: 82%

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Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in class III patients: a non-randomized clinical trial

2019

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Background The use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients. The aim of this study was to evaluate the treatment of class III patients with maxillary retrusion, using orthodontic mini-implants (MI) associated with intermaxillary elastics in comparison with the rapid maxillary expansion and facemask protocol (RME/FM). Methods In this prospective non-randomized clinical trial, the sample of 24 participants between 7 and 12 years of age (median age of 10.0 years and interquartile range = 3.0 years), at the stage prior to the pre-pubertal growth spurt, was divided in two groups. In group facemask (FM) ( n = 12), the individuals received orthopedic treatment with RME/FM. In group MI ( n = 12), two mini-implants were inserted in the region close to the maxillary first molar roots, and the other two in the region of the mandibular canines. Initial and final lateral teleradiographs were taken for cephalometric evaluation of all the cases. Statistical analysis included the Mann-Whitney, Wilcoxon, and Fisher’s exact tests. The level of significance was 5% (α = 0.05). Results Improvement was verified in the facial profile and occlusion of the participants, showing advancement of the maxilla in the two groups, with significant differences ( P ≤ 0.05) between T0 and T1 in the following measurements: SNA, ANB, Wits, Co-A, Co-Gn, NAP, A-Npog, overjet, and molar relationship. There was no statistically significant intergroup difference ( P > 0.05) in the cephalometric measurements evaluated, but the time of treatment was significant, and was faster for group MI. Conclusions The protocol with mini-implants may be an option for the correction of Class III due to maxillary deficiency.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 82%

Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in class III patients: a non-randomized clinical trial

2019

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“…Soft tissue growth in the lower lip and chin area is more restrained in horizontal and vertical direction in type 1 BAMP group when compared with type 2 BAMP. [ 24 ]…”

Section: Resultsmentioning

confidence: 99%

Bone-anchored maxillary protraction (BAMP): A review

Shrinivasa¹,

Sudhakar²,

Kannan³

et al. 2022

J Orthodont Sci

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INTRODUCTION: Protraction therapy for maxillary deficiency in the treatment of skeletal class III malocclusion involves the use of facemask. Conventionally facemask has been anchored to the maxillary dentition, which is responsible for some of the counter-productive effects of facemask therapy including backward and downward rotation of the chin, increase in the lower anterior facial height, proclination of maxillary incisors, retroclination of mandibular incisors apart from mesialization of maxillary molars with extrusion and decreased overbite. AIM: The aim of this article is to highlight the nuances of Bone-Anchored Maxillary Protraction (BAMP) including a literature review, which is comprehensive and narrative and comparing the different techniques involved such as type 1 BAMP versus type 2 BAMP and BAMP versus facemask. MATERIALS AND METHODS: A computerized search was performed in electronic databases such as PubMed, PubMed Central, Cochrane, Embase, DOAJ, and Google scholar using key words such as “bone-anchored maxillary protraction” and “BAMP.” The search was confined to articles in English published till March 2021. Forty-seven case-controlled, cross-sectional, retrospective and prospective studies, as well as systematic reviews and meta-analysis were included in this article, which were limited to human subjects. A hand search of the reference lists of the included articles was also carried out to include missed out articles. CONCLUSION: To overcome these drawbacks, BAMP was introduced, which causes both maxillary protraction, restraint of mandibular growth with minimal dentoalveolar changes. BAMP is used widely nowadays in the treatment of skeletal class III malocclusion.

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“…Recently, soft tissue responses to underlying skeletal changes have been evaluated using 3D imaging technology, such as 3D landmarks, color mapping, and volumetric difference [ 15 , 17 – 20 ]. However, these results did not completely represent the 3D relationship between the corresponding soft-to-hard tissue changes in various face subunits [ 42 – 46 ]. 3D CBCT imaging is suitable for evaluating the facial soft tissue changes caused by orthognathic surgery according to the underlying bone movements because CBCT simultaneously displays both soft and bone tissues.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism

Weng

et al. 2018

PLoS ONE

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Both deep understanding and reliable prediction of postoperative soft tissue changes are crucial for planning orthognathic surgery. Instead of estimating soft tissue responses by measuring individual landmark changes, this study aimed to investigate the relationship (ratio) between soft and hard tissue movements in different facial regions through three-dimensional cone-beam computed tomography (CBCT). Preoperative and postoperative CBCT images were superimposed using the surface registration method on the basis of the cranial base, and 10 facial regions of interest were defined. Region-based volumetric subtractions between the preoperative and postoperative segments were performed. The volumetric differences and surface of each region were used to estimate the average movement. Correlation and regression analyses were performed to examine the relationships between the corresponding soft and hard tissue movements. An overall pattern of facial soft tissue movement was observed in patients with prognathism who underwent orthognathic surgery. The experiment results have shown that mean ratios for the average soft-to-hard tissue movements in the facial regions varied, which may not exactly be similar to the published reports because of the population biocharacteristics and study methods, but the trend is in agreement with the previous studies. Additionally, the prediction capability of the regression model was significantly high, ranging from 0.786 to 0.857, in upper lip, upper vermilion, and chin regions, thus demonstrating that the skin outline changes in these critical regions could be reliably predicted from the underlying bone movements. These results could likely be applied in future soft tissue simulation in orthognathic surgery.

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Three-dimensional assessment of soft tissue changes associated with bone-anchored maxillary protraction protocols

Cited by 24 publications

References 40 publications

Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in class III patients: a non-randomized clinical trial

Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in class III patients: a non-randomized clinical trial

Bone-anchored maxillary protraction (BAMP): A review

Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism

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