Int J Stomatol ›› 2021, Vol. 48 ›› Issue (3): 354-361.doi: 10.7518/gjkq.2021039

• Reviews • Previous Articles     Next Articles

Research progress on maxillary protraction methods and auxiliary maxillary expansion for skeletal Class Ⅲ malocclusion

Zhang Shizhen1(),Lai Wenli2()   

  1. 1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China
    2. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2020-09-11 Revised:2021-01-17 Online:2021-05-01 Published:2021-05-14
  • Contact: Wenli Lai E-mail:1429339354@qq.com;wenlilai@scu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(82071147)

Abstract:

Maxillary protraction is an effective method for the early treatment of maxillary deficiency. The application of mini-implant anchorage enhances the bone effect of maxillary protraction and improves the stability of early correction. Maxillary expansion activates or opens maxillary sutures, and whether or not the auxiliary maxillary expansion enhances maxillary protraction has attracted the attention of clinicians. To provide reference for the clinical application of this technique, this article reviews the selection of early treatment for skeletal Class Ⅲ malocclusion, the effectiveness of alternative protraction methods, and the influence of maxillary arch expansion on maxillary protraction.

Key words: skeletal Class Ⅲ malocclusion, maxillary protraction, bone anchorage, maxillary expansion

CLC Number: 

  • R783.5

TrendMD: 

Tab 1

Comparing the effect of RME and Alt-RAMEC on maxillary protraction"

研究 年龄/岁 结果 P
RME+FM前牵引 Alt-RAMEC+FM前牵引
Isci等[52](2010年) 11~12 2.33 mm(A’) 4.13 mm(A’) >0.05
Liu等[53](2015年) 7~13 2.11 mm(A’) 3.04 mm(A’) <0.05
Masucci等[43](2014年) 6~8 1.5°(SNA’) 2.7°(SNA’) <0.05
Fischer等[54](2018年) 6~7 2.0 mm(A’) 2.0 mm(A’) <0.05
Onem Ozbilen等[55](2019年) 9~10 2.53 mm(A’) 2.73 mm(A’) >0.05
[1] Lin M, Xie C, Yang H, et al. Prevalence of malocclusion in Chinese schoolchildren from 1991 to 2018: a systematic review and meta-analysis[J]. Int J Paediatr Dent, 2020,30(2):144-155.
[2] Staudt CB, Kiliaridis S. Different skeletal types underlying Class Ⅲ malocclusion in a random population[J]. Am J Orthod Dentofacial Orthop, 2009,136(5):715-721.
doi: 10.1016/j.ajodo.2007.10.061
[3] Kambara T. Dentofacial changes produced by extraoral forward force in the Macaca irus[J]. Am J Orthod, 1977,71(3):249-277.
pmid: 402814
[4] Clemente R, Contardo L, Greco C, et al. Class Ⅲ treatment with skeletal and dental anchorage: a review of comparative effects[J]. Biomed Res Int, 2018,2018:7946019.
doi: 10.1155/2018/7946019 pmid: 30057910
[5] Lee SH, Koh SD, Chung DH, et al. Comparison of skeletal anchorage and tooth-borne maxillary protraction followed by fixed appliance in Class Ⅲ malocclusion[J]. Eur J Orthod, 2020,42(2):193-199.
doi: 10.1093/ejo/cjz086
[6] Nguyen T, Cevidanes L, Cornelis MA, et al. Three-dimensional assessment of maxillary changes associated with bone anchored maxillary protraction[J]. Am J Orthod Dentofacial Orthop, 2011,140(6):790-798.
doi: 10.1016/j.ajodo.2011.04.025 pmid: 22133943
[7] Liou EJ. Effective maxillary orthopedic protraction for growing Class Ⅲ patients: a clinical application simulates distraction osteogenesis[J]. Prog Orthod, 2005,6(2):154-171.
[8] Mao JJ. Mechanobiology of craniofacial sutures[J]. J Dent Res, 2002,81(12):810-816.
pmid: 12454093
[9] Mao JJ, Wang X, Kopher RA. Biomechanics of craniofacial sutures: orthopedic implications[J]. Angle Orthod, 2003,73(2):128-135.
[10] Elnagar MH, Elshourbagy E, Ghobashy S, et al. Three-dimensional assessment of soft tissue changes associated with bone-anchored maxillary protraction protocols[J]. Am J Orthod Dentofacial Orthop, 2017,152(3):336-347.
doi: 10.1016/j.ajodo.2017.01.022
[11] Rosen HM. Lip-nasal aesthetics following Le Fort Ⅰ osteotomy[J]. Plast Reconstr Surg, 1988,81(2):171-182.
pmid: 3336648
[12] Mandall N, Cousley R, DiBiase A, et al. Early Class Ⅲ protraction facemask treatment reduces the need for orthognathic surgery: a multi-centre, two-arm pa-rallel randomized, controlled trial[J]. J Orthod, 2016,43(3):164-175.
doi: 10.1080/14653125.2016.1201302 pmid: 27564126
[13] Nardoni DN, Siqueira DF, Cardoso Mde A, et al. Cephalometric variables used to predict the success of interceptive treatment with rapid maxillary expansion and face mask. A longitudinal study[J]. Dental Press J Orthod, 2015,20(1):85-96.
doi: 10.1590/2176-9451.20.1.085-096.oar
[14] De Clerck HJ, Proffit WR. Growth modification of the face: a current perspective with emphasis on Cla-ss Ⅲ treatment[J]. Am J Orthod Dentofacial Orthop, 2015,148(1):37-46.
doi: 10.1016/j.ajodo.2015.04.017 pmid: 26124026
[15] 赵志河, 赵美英. 上颌复合体及上颌牙弓阻力中心位置的研究[J]. 口腔正畸学杂志, 1994,1(1):25-26.
Zhao ZH, Zhao MY. Study on the center of resistance of maxillary complex and maxillary arch[J]. J Orthod, 1994,1(1):25-26.
[16] Yan X, He W, Lin T, et al. Three-dimensional finite element analysis of the craniomaxillary complex du-ring maxillary protraction with bone anchorage vs conventional dental anchorage[J]. Am J Orthod Dentofacial Orthop, 2013,143(2):197-205.
doi: 10.1016/j.ajodo.2012.09.019
[17] Yepes E, Quintero P, Rueda ZV, et al. Optimal force for maxillary protraction facemask therapy in the ear-ly treatment of Class Ⅲ malocclusion[J]. Eur J Orthod, 2014,36(5):586-594.
doi: 10.1093/ejo/cjt091
[18] Kircelli BH, Pektas ZO. Midfacial protraction with skeletally anchored face mask therapy: a novel approach and preliminary results[J]. Am J Orthod Dentofacial Orthop, 2008,133(3):440-449.
doi: 10.1016/j.ajodo.2007.06.011
[19] Lee NK, Yang IH, Baek SH. The short-term treatment effects of face mask therapy in Class Ⅲ patients based on the anchorage device: miniplates vs rapid maxillary expansion[J]. Angle Orthod, 2012,82(5):846-852.
doi: 10.2319/090811-584.1
[20] Sar C, Arman-Özçırpıcı A, Uçkan S, et al. Comparative evaluation of maxillary protraction with or without skeletal anchorage[J]. Am J Orthod Dentofacial Orthop, 2011,139(5):636-649.
doi: 10.1016/j.ajodo.2009.06.039
[21] Tripathi T, Rai P, Singh N, et al. A comparative eva-luation of skeletal, dental, and soft tissue changes with skeletal anchored and conventional facemask protraction therapy[J]. J Orthod Sci, 2016,5(3):92-99.
doi: 10.4103/2278-0203.186166 pmid: 27556021
[22] Nienkemper M, Wilmes B, Franchi L, et al. Effectiveness of maxillary protraction using a hybrid hyrax-facemask combination: a controlled clinical study[J]. Angle Orthod, 2015,85(5):764-770.
doi: 10.2319/071614-497.1 pmid: 25393800
[23] Al Dayeh A, Williams RA, Trojan TM, et al. Deformation of the zygomaticomaxillary and nasofrontal sutures during bone-anchored maxillary protraction and reverse-pull headgear treatments: an ex-vivo study[J]. Am J Orthod Dentofacial Orthop, 2019,156(6):745-757.
doi: 10.1016/j.ajodo.2018.12.019
[24] Bozkaya E, Yüksel AS, Bozkaya S. Zygomatic miniplates for skeletal anchorage in orthopedic correction of Class Ⅲ malocclusion: a controlled clinical trial[J]. Korean J Orthod, 2017,47(2):118-129.
doi: 10.4041/kjod.2017.47.2.118 pmid: 28337421
[25] De Clerck HJ, Cornelis MA, Cevidanes LH, et al. Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency[J]. J Oral Maxillofac Surg, 2009,67(10):2123-2129.
doi: 10.1016/j.joms.2009.03.007
[26] Esenlik E, Ağlarcı C, Albayrak GE, et al. Maxillary protraction using skeletal anchorage and intermaxillary elastics in Skeletal Class Ⅲ patients[J]. Korean J Orthod, 2015,45(2):95-101.
doi: 10.4041/kjod.2015.45.2.95 pmid: 25798416
[27] Fakharian M, Bardideh E, Abtahi M. Skeletal Class Ⅲ malocclusion treatment using mandibular and ma-xillary skeletal anchorage and intermaxillary elastics: a case report[J]. Dental Press J Orthod, 2019,24(5):52-59.
doi: S2176-94512019000500052 pmid: 31721947
[28] De Clerck H, Cevidanes L, Baccetti T. Dentofacial effects of bone-anchored maxillary protraction: a controlled study of consecutively treated Class Ⅲ patients[J]. Am J Orthod Dentofacial Orthop, 2010,138(5):577-581.
doi: 10.1016/j.ajodo.2009.10.037 pmid: 21055597
[29] De Clerck H, Nguyen T, de Paula LK, et al. Three-dimensional assessment of mandibular and glenoid fossa changes after bone-anchored Class Ⅲ interma-xillary traction[J]. Am J Orthod Dentofacial Orthop, 2012,142(1):25-31.
doi: 10.1016/j.ajodo.2012.01.017 pmid: 22748987
[30] Ağlarcı C, Esenlik E, Fındık Y. Comparison of short-term effects between face mask and skeletal ancho-rage therapy with intermaxillary elastics in patients wi-th maxillary retrognathia[J]. Eur J Orthod, 2016,38(3):313-323.
doi: 10.1093/ejo/cjv053 pmid: 26219549
[31] Cevidanes L, Baccetti T, Franchi L, et al. Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion[J]. Angle Orthod, 2010,80(5):799-806.
doi: 10.2319/111709-651.1 pmid: 20578848
[32] Hino CT, Cevidanes LH, Nguyen TT, et al. Three-dimensional analysis of maxillary changes associated with facemask and rapid maxillary expansion compared with bone anchored maxillary protraction[J]. Am J Orthod Dentofacial Orthop, 2013,144(5):705-714.
doi: 10.1016/j.ajodo.2013.07.011
[33] de Souza RA, Rino Neto J, de Paiva JB. Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in Class Ⅲ patients: a non-randomized clinical trial[J]. Prog Orthod, 2019,20(1):35.
doi: 10.1186/s40510-019-0288-7
[34] Elnagar MH, Elshourbagy E, Ghobashy S, et al. Comparative evaluation of 2 skeletally anchored maxillary protraction protocols[J]. Am J Orthod Dentofacial Orthop, 2016,150(5):751-762.
doi: 10.1016/j.ajodo.2016.04.025
[35] Wu Z, Zhang X, Li Z, et al. A Bayesian network meta-analysis of orthopaedic treatment in Class Ⅲ malo-cclusion: maxillary protraction with skeletal ancho-rage or a rapid maxillary expander[J]. Orthod Craniofac Res, 2020,23(1):1-15.
[36] Lin Y, Guo R, Hou L, et al. Stability of maxillary protraction therapy in children with Class Ⅲ malocclusion: a systematic review and meta-analysis[J]. Clin Oral Investig, 2018,22(7):2639-2652.
doi: 10.1007/s00784-018-2363-8
[37] Liu SS, Kyung HM, Buschang PH. Continuous for-ces are more effective than intermittent forces in expanding sutures[J]. Eur J Orthod, 2010,32(4):371-380.
doi: 10.1093/ejo/cjp103
[38] Heymann GC, Cevidanes L, Cornelis M, et al. Three-dimensional analysis of maxillary protraction with intermaxillary elastics to miniplates[J]. Am J Orthod Dentofacial Orthop, 2010,137(2):274-284.
doi: 10.1016/j.ajodo.2009.07.009 pmid: 20152686
[39] Suda N, Ishii-Suzuki M, Hirose K, et al. Effective treatment plan for maxillary protraction: is the bone age useful to determine the treatment plan[J]. Am J Orthod Dentofacial Orthop, 2000,118(1):55-62.
doi: 10.1067/mod.2000.104491
[40] Cha KS. Skeletal changes of maxillary protraction in patients exhibiting skeletal Class Ⅲ malocclusion: a comparison of three skeletal maturation groups[J]. Angle Orthod, 2003,73(1):26-35.
[41] Meyns J, Brasil DM, Mazzi-Chaves JF, et al. The clinical outcome of skeletal anchorage in interceptive treatment (in growing patients) for Class Ⅲ malocclusion[J]. Int J Oral Maxillofac Surg, 2018,47(8):1003-1010.
doi: 10.1016/j.ijom.2018.04.011
[42] Haas AJ. Palatal expansion: just the beginning of dentofacial orthopedics[J]. Am J Orthod, 1970,57(3):219-255.
pmid: 5263785
[43] Masucci C, Franchi L, Giuntini V, et al. Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class Ⅲ malocclusion: a controlled study[J]. Orthod Craniofac Res, 2014,17(4):259-269.
doi: 10.1111/ocr.2014.17.issue-4
[44] Turley PK. Orthopedic correction of Class Ⅲ malocclusion with palatal expansion and custom protraction headgear[J]. J Clin Orthod, 1988,22(5):314-325.
pmid: 3075214
[45] Vaughn GA, Mason B, Moon HB, et al. The effects of maxillary protraction therapy with or without ra-pid palatal expansion: a prospective, randomized cli-nical trial[J]. Am J Orthod Dentofacial Orthop, 2005,128(3):299-309.
doi: 10.1016/j.ajodo.2005.04.030
[46] Zhang W, Qu HC, Yu M, et al. The effects of maxillary protraction with or without rapid maxillary expansion and age factors in treating Class Ⅲ malocclusion: a meta-analysis[J]. PLoS One, 2015,10(6):e0130096.
[47] Foersch M, Jacobs C, Wriedt S, et al. Effectiveness of maxillary protraction using facemask with or wi-thout maxillary expansion: a systematic review and meta-analysis[J]. Clin Oral Investig, 2015,19(6):1181-1192.
doi: 10.1007/s00784-015-1478-4 pmid: 25982454
[48] Saadia M, Torres E. Sagittal changes after maxillary protraction with expansion in Class Ⅲ patients in the primary, mixed, and late mixed dentitions: a longitudinal retrospective study[J]. Am J Orthod Dentofacial Orthop, 2000,117(6):669-680.
doi: 10.1016/S0889-5406(00)70176-4
[49] Liou EJ, Tsai WC. A new protocol for maxillary protraction in cleft patients: repetitive weekly protocol of alternate rapid maxillary expansions and constrictions[J]. Cleft Palate Craniofac J, 2005,42(2):121-127.
doi: 10.1597/03-107.1
[50] Al-Mozany SA, Dalci O, Almuzian M, et al. A no-vel method for treatment of Class Ⅲ malocclusion in growing patients[J]. Prog Orthod, 2017,18(1):40.
doi: 10.1186/s40510-017-0192-y pmid: 29226300
[51] Çelebi F, Çelikdelen M. Comparison of the changes following two treatment approaches: rapid maxillary expansion versus alternate rapid maxillary expansion and constriction[J]. Turk J Orthod, 2020,33(1):1-7.
doi: 10.5152/TurkJOrthod.
[52] Isci D, Turk T, Elekdag-Turk S. Activation-deactivation rapid palatal expansion and reverse headgear in Class Ⅲ cases[J]. Eur J Orthod, 2010,32(6):706-715.
doi: 10.1093/ejo/cjq006
[53] Liu W, Zhou Y, Wang X, et al. Effect of maxillary protraction with alternating rapid palatal expansion and constriction vs expansion alone in maxillary retrusive patients: a single-center, randomized control-led trial[J]. Am J Orthod Dentofacial Orthop, 2015,148(4):641-651.
doi: 10.1016/j.ajodo.2015.04.038
[54] Fischer B, Masucci C, Ruellas A, et al. Three-dimensional evaluation of the maxillary effects of two orthopaedic protocols for the treatment of Class Ⅲ malocclusion: a prospective study[J]. Orthod Craniofac Res, 2018,21(4):248-257.
doi: 10.1111/ocr.2018.21.issue-4
[55] Onem Ozbilen E, Yilmaz HN, Kucukkeles N. Comparison of the effects of rapid maxillary expansion and alternate rapid maxillary expansion and constriction protocols followed by facemask therapy[J]. Korean J Orthod, 2019,49(1):49-58.
doi: 10.4041/kjod.2019.49.1.49 pmid: 30603625
[56] Cantarella D, Savio G, Grigolato L, et al. A new methodology for the digital planning of micro-implant-supported maxillary skeletal expansion[J]. Med Devices (Auckl), 2020,13:93-106.
[57] Maino G, Turci Y, Arreghini A, et al. Skeletal and dentoalveolar effects of hybrid rapid palatal expansion and facemask treatment in growing skeletal Class Ⅲ patients[J]. Am J Orthod Dentofacial Orthop, 2018,153(2):262-268.
doi: 10.1016/j.ajodo.2017.06.022
[58] MacGinnis M, Chu H, Youssef G, et al. The effects of micro-implant assisted rapid palatal expansion (MARPE) on the nasomaxillary complex: a finite e-lement method (FEM) analysis[J]. Prog Orthod, 2014,15:52.
doi: 10.1186/s40510-014-0052-y pmid: 25242527
[59] Hartono N, Soegiharto BM, Widayati R. The diffe-rence of stress distribution of maxillary expansion u-sing rapid maxillary expander (RME) and maxillary skeletal expander (MSE)-a finite element analysis[J]. Prog Orthod, 2018,19(1):33.
doi: 10.1186/s40510-018-0229-x
[60] Park JH, Bayome M, Zahrowski JJ, et al. Displacement and stress distribution by different bone-borne palatal expanders with facemask: a 3-dimensional finite element analysis[J]. Am J Orthod Dentofacial Orthop, 2017,151(1):105-117.
doi: 10.1016/j.ajodo.2016.06.026
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