Relative effectiveness of facemask therapy with alternate maxillary expansion and constriction in the early treatment of Class III malocclusion

医学 错牙合 口腔正畸科 牙科
作者
Yuyao Liu,Renya Hou,Hairu Jin,Xin Zhang,Zuping Wu,Zixuan Li,Jie Guo
出处
期刊:American Journal of Orthodontics and Dentofacial Orthopedics [Elsevier BV]
卷期号:159 (3): 321-332 被引量:20
标识
DOI:10.1016/j.ajodo.2019.12.028
摘要

•Alternate rapid maxillary expansion and constriction (Alt-RAMEC) was studied. •Results were compared with facemask therapy and rapid maxillary expansion. •Alt-RAMEC was performed simultaneously with maxillary protraction. •Alt-RAMEC along with facemask therapy produced more favorable skeletal effects. •No short-term abnormal dental, periodontal, or craniofacial changes were observed. Introduction This study aimed to investigate the relative efficacy of maxillary protraction combined with a modified alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol compared with conventional protocols in the early orthopedic treatment of skeletal Class III malocclusion. Methods A sample of 39 patients was divided into 3 groups on the basis of different interventions. Conventional facemask (FM) with splint-type intraoral devices was performed in the FM group (7 males and 5 females; mean age, 9.53 ± 1.37 years). Maxillary expansion with an activation rate of 0.5 mm/d (twice a day) followed by FM therapy was applied in the rapid maxillary expansion group (RME/FM) (6 males and 6 females; mean age, 9.31 ± 1.60 years). In the Alt-RAMEC/FM group (7 males and 8 females; mean age, 10.01 ± 1.31 years), Alt-RAMEC was started simultaneously and throughout the entire course of maxillary protraction, with repetitive alternations between activation and deactivation of expanders (0.5 mm/d for 7 days). The patients in all groups were instructed to wear FMs for a minimum of 12 h/d. Pretreatment and posttreatment lateral cephalograms were all traced and measured. Results The Alt-RAMEC group showed statistically more significant maxillary advancement than other groups (A-VRP, 3.87 mm vs 3.04 mm [RME/FM], vs 2.04 mm [FM]; P <0.05). Analysis of variance did not reveal significant intergroup differences in palatal plane angulation changes (P >0.05). No pronounced mandibular clockwise rotations were noted in the Alt-RAMEC/FM group with distinct intergroup differences (P <0.05). There were more skeletal effects (88.7%) during overjet correction in the Alt-RAMEC/FM protocol. Conclusions A combination of the modified Alt-RAMEC protocol with FM revealed more favorable skeletal effects compared with FM and RME/FM protocols in treating prepubertal patients with maxillary deficiency.
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