Clinical Oral Investigations

, Volume 22, Issue 7, pp 2639–2652 | Cite as

Stability of maxillary protraction therapy in children with Class III malocclusion: a systematic review and meta-analysis

  • Yifan Lin
  • Runzhi Guo
  • Liyu Hou
  • Zhen Fu
  • Weiran LiEmail author
Original Article



The objective of this study was to evaluate the stability of treatment effects of maxillary protraction therapy in Class III children.

Materials and methods

Multiple electronic databases were searched from 01/1996 to 10/2016. Randomized clinical trials, controlled clinical trials, and cohort studies with untreated Class III controls and a follow-up over 2 years were considered for inclusion. The methodological quality of the studies and publication bias were evaluated. Mean differences and 95% confidence intervals (CI) of six variables (SNA, SNB, ANB, mandibular plane angle, overjet, and lower incisor angle) were calculated.


Ten studies were included in the qualitative analysis, and four studies were included in the quantitative analysis. Compared with the control group, after treatment, the treated group showed significant changes: SNA +1.79° (95% CI: 1.23, 2.34), SNB −1.16° (95% CI −2.08, −0.24), ANB +2.92° (95% CI 2.40, 3.44), mandibular plane angle +1.41° (95% CI 0.63, 2.20), overjet +3.94 mm (95% CI 2.17, 5.71) and lower incisor angle −3.07° (95% CI −4.92, −1.22). During follow-up, the changes in five variables reflected significant relapse. Overall, the treated group showed significant changes only in ANB +1.66° (95% CI 0.97, 2.35) and overjet +2.41 mm (95% CI 1.60, 3.23).


Maxillary protraction can be a short-term effective therapy and might improve sagittal skeletal and dental relationships in the medium term. But some skeletal and dental variables showed significant relapse during the follow-up period. Long-term studies are still required to further evaluate its skeletal benefits.

Clinical relevance

The study evaluated the medium-term stability of skeletal and dental effects of maxillary protraction in Class III children and discussed whether the therapy can reduce the need for orthognathic surgery.


Maxillary protraction therapy Class III children Skeletal and dental changes Medium-term stability Systematic review and meta-analysis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Yifan Lin
    • 1
  • Runzhi Guo
    • 1
  • Liyu Hou
    • 1
  • Zhen Fu
    • 1
  • Weiran Li
    • 1
    Email author
  1. 1.Department of OrthodonticsPeking University School and Hospital of StomatologyBeijingChina

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