Effects of Alt-RAMEC protocol with facemask therapy in cleft lip palate patients in a sample of Pakistani population.

OBJECTIVE: The objective of the study is to evaluate the skeletal, dentoalveolar and soft tissue changes before and after treatment with Alt-RAMEC protocol and protraction headgear in comparison to the controls. MATERIAL AND METHODS: A quasi experimental study was conducted in the orthodontic department on 60 patients of cleft lip and palate. These patients were divided into two groups. Group I was the Alt-RAMEC group that underwent Alt-RAMEC protocol followed by facemask therapy while group II was the control group that underwent RME and facemask therapy. Total treatment time in both the groups was approximately 6 to 7 months. Mean and standard deviation was calculated for all the quantitative variables. Pre and post treatment changes between treatment and control groups were made using paired t-test. Intergroup comparison between treatment and control group was analyzed using independent t-test. Significance for all tests was predetermined at a P-value of ≤ 0.05. RESULTS: The Alt-RAMEC group showed significant forward movement of maxilla and improvement in the maxillary base. A remarkable improvement in SNA was seen. The overall outcome was better maxillo-mandibular relationship as shown by positive ANB values and angle of convexity. More effect on maxilla and least effect on mandible was notified with Alt-RAMEC protocol and facemask therapy. Improvement in transverse relationship was also evident in the Alt-RAMEC group. CONCLUSION: Alt-RAMEC protocol in combination with protraction headgear is a better alternative to treat cleft lip and palate patients in comparison to the conventional protocol.

Evaluation of various cephalometric measurements to predict the prognosis of early Class III malocclusion treatment / 대한치과교정학회지

The aims of this study were to investigate the differences in the early craniofacial morphology of Class III malocclusions with good, fair and poor occlusal stability and to elucidate a key determinant for distinguishing the cases. Lateral cephalograms of 30 subjects with Class III malocclusion in the mixed dentition were analyzed at the start of treatment (mean age of 8.58+/-1.47). All subjects were re-evaluated after a mean period of 7.50+/-1.94 years comprising active treatment and retention. At this time, the samples were divided into three groups: good (10 subjects), fair (10 subjects) and poor (10 subjects) occlusal stability groups. According to the results of ANOVA, there were significant morphological differences in the early stage among the good, fair and poor occlusal stability groups, especially in variables that represented the vertical skeletal relationships. As well, there were already more dental compensations in the poor occlusal stability group. Stepwise discriminant analysis on the measurements at the time of first observation identified only one predictive variable: AB to mandibular plane angle (AB-MP). With this discriminant function, 83.3% of the original grouped cases were correctly classified and the canonical correlation coefficient was 0.857. In conclusion, AB-MP can be a possible predictor for the eventual prognosis of early Class III treatment. If it is below 60, the prognosis of early Class III treatment is expected to be poor, while if it is above 65, a good prognosis is expected.