Treatment of Maxillary Retrusion-Face Mask with or without RPE?

Elona Kongo

Faculty of Medical Science, Albanian University, Albania


Background/Aim: Maxillary transverse deficiency often combines with retruded maxillary skeletal position causing a skeletal class III malocclusion. In these cases combination of rapid palatal expander and a facial mask to protract the maxilla is a very effective treatment protocol. When the maxilla is not deficient is it necessary to use palatal expansion before protracting? Should we use this combination because it has been proved to be effective? The aim of this paper is to show that maxillary protraction is also effective when applied without expanding the maxilla although there are some statistically significant changes.

Material and Methods: Two groups of 20 patients each, were created for this study. The first group were treated with rapid palatal expansion and face mask. In the second group, patients were treated only with face mask.

Results: Measurements made at T0 (prior to treatment) and those at T1 (after treatment) were statistically analyzed. At the end of the treatment patients of the 1stgroup showed significant difference for the values of SNA, SNB, ANB angles (p=0.000). Significant changes were observed also for the second group (SNA, SNB, ANB). The only differences between the two groups were observed regarding SNA angle (p=0.040) and maxillary incisor inclination (p=0.028).

Conclusions: At the end of treatment, all patients showed skeletal class III correction and improved facial appearance. Significant changes of SNA angle were observed for each group. There were also significant changes in the position of the mandible. These changes contributed in skeletal class III correction but there was no significant difference between them.

1. Kapust AJ, Sinclair PM, Turley PK. Cephalometric effects of facemask/expansion therapy in Class III children: a comparison of three age groups. Am J Orthod Dentofacial Orthop, 1998;113:204-212.Google Scholar

2. Baik HS. Clinical results of the maxillary protraction in Korean children. Am J Orthod Dentofacial Orthop, 1995;108:583-592.Google Scholar

3. Baccetti T, McGill JS, Franchi L, McNamara JA Jr, Tollaro I. Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop, 1998;113:333-343.Google Scholar

4. Ellis E, McNamara JA Jr. Components of adult Class III malocclusion. J Oral Maxillofac Surg, 1984;42:295-305.Google Scholar

5. Guyer EC, Ellis EE, McNamara JA Jr, Behrents RG. Components of Class III malocclusionin juveniles and adolescents. Angle Orthod, 1986:56:7-30.Google Scholar

6. Ishii H, Morita S, Takeuchi Y, Nakamura S. Treatment effect of combined maxillary protraction and chincap appliance in severe skeletal Class III cases. Am J Orthod Dentofacial Orthop, 1987;92:304-312.Google Scholar

7. Kim JH, Viana MA, Graber TM, Omerza FF, BeGole EA. The effectiveness of protraction face mask therapy: a meta analysis. Am J Orthod Dentofacial Orthop, 1999;115:675-685.Google Scholar

8. Macdonald KE, Kapust AJ, Turley PK. Cephalometric changes after the correction of Class III malocclusion with maxillary expansion/facemask therapy. Am J Orthod Dentofacial Orthop, 1999;116:13-24.Google Scholar

9. McNamara JA Jr. An orthopaedic approach to the treatment of Class III malocclusion in growing children. J Clin Orthod, 1987;21:598-608.Google Scholar

10. Nartallo-Turley PE, Turley PK. Cephalometric effects of combined palatal expansion and facemask therapy on class III malocclusion. Angle Orthod, 1998;68:217-224.Google Scholar

11. Braun S. Extra oral appliances:a twenty-first century update. Am J Orthod Dentofacial Orthop, 2004;125:624-629.Google Scholar

12. Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal class III children treated by a modified protraction headgear and a chin cup; a longitudinal cephalometric appraisal. Eur J Orthod, 1993;15:211-221.Google Scholar