ABSTRACT
Objective@#Surgically assisted maxillary protraction is an alternative protocol in severe Class III cases or after the adolescent growth spurt involving increased maxillary advancement. Correction of the maxillary deficiency has been suggested to improve pharyngeal airway dimensions. Therefore, this retrospective study aimed to analyze the airway changes cephalometrically following surgically assisted maxillary protraction with skeletal anchorage and Class III elastics. @*Methods@#The study population consisted of 15 Class III patients treated with surgically assisted maxillary protraction combined with skeletal anchorage and Class III elastics (mean age: 12.9 ± 1.2 years). Growth changes were initially assessed for a mean of 5.5 ± 1.6 months prior to treatment. Airway and skeletal changes in the control (T0), pre-protraction (T1), post-protraction (T2), and follow-up (T3) periods were monitored and compared using lateral cephalometric radiographs. Statistical significance was set at p 0.05). No statistically significant changes were observed in the airway parameters in the follow-up period either. However, Sella to Gonion distance increased significantly (p < 0.05) during the follow-up period. @*Conclusions@#No significant changes in pharyngeal airway parameters were found during the control, maxillary protraction, and follow-up periods. Moreover, the significant increases in the skeletal parameters during maxillary protraction were maintained in the long-term.
ABSTRACT
OBJECTIVE: The aim of this retrospective study was to evaluate and compare the changes in the pharyngeal airway (PA), maxillary sinus volume, and skeletal parameters after rapid maxillary expansion (RME) and alternate rapid maxillary expansion and constriction (Alt-RAMEC) followed by facemask (FM) therapy. METHODS: The records of 40 patients with skeletal Class III malocclusion due to maxillary retrognathism were collected, and the patients were assigned into two groups. The first group comprised 8 male and 12 female patients (mean age, 10.0 ± 1.1 years) treated using RME/FM for an average of 10 months. The second group comprised 10 male and 10 female patients (mean age, 9.64 ± 1.3 years) treated using Alt-RAMEC/FM for an average of 12 months. Cone-beam computed tomography images acquired before (T0) and after treatment (T1) were evaluated. RESULTS: Regarding the skeletal effects, significant differences between the groups were the increase in ANS-HRP (perpendicular distance of ANS to the horizontal reference plane, 0.99 mm, p <0.05) in the Alt-RAMEC/FM group and the decrease in PP-SN (palatal plane to Sella-Nasion plane, 0.93°, p < 0.05) in the RME/FM group. Maxillary sinus volumes increased significantly in both the groups, and the increase was statistically significantly higher in the Alt-RAMEC/FM group. Although no significant intergroup differences were observed in PA volumes, both lower (1,011.19 mm3) and total (1,601.21 mm3), PA volume increased significantly in the Alt-RAMEC/FM group. CONCLUSIONS: The different expansion devices and protocols used with FM therapy do not seem to affect the forward movement of the maxilla and PA volumes. In contrast, the increase in maxillary sinus volume was greater in the Alt-RAMEC/FM protocol.
Subject(s)
Female , Humans , Male , Cone-Beam Computed Tomography , Constriction , Malocclusion , Maxilla , Maxillary Sinus , Palatal Expansion Technique , Retrognathia , Retrospective StudiesABSTRACT
Anterior open bite is a challenging malocclusion that Orthodontists deal with in their day to day practice. Many treatment options exist for its correction and the aim of this study was to evaluate the clinical effects of reverse curved NiTi arches on anterior open bite treatment in adolescents and to investigate whether true intrusion of molars could be achieved in this special age group. The study sample consisted of 15 patients [age ranged from 12.2 to 14 years]. All presented a high angle skeletal pattern and an anterior open bite. After initial leveling, upper accentuated curve and lower reverse-curve 0.016 × 0.022 inch arch wires were placed, with anterior elastics applied in the canine regions. Cephalometric assessment was carried out on lateral head films taken at the beginning of treatment and on average 3 months after open bite closure was obtained. The upper and lower incisors, the upper and lower first premolars and the upper and lower first molars were uprighted and extruded. The overbite was increased significantly due to the extrusion of the upper and lower incisors, while the overjet was reduced due to uprightening of both upper and lower incisors. This technique was effective in the treatment of open bite in young adolescents although no true intrusion was achieved in the molar region. Further studies are suggested to investigate the long term stability of our results