Stability of maxillary protraction therapy in children with Class III malocclusion: a systematic review and meta-analysis
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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.
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.
KeywordsMaxillary 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.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
- 5.Guyer EC, Ellis EE 3rd, McNamara JA Jr, Behrents RG (1986) Components of Class III malocclusion in juveniles and adolescents. Angle Orthod 56(1):7–30. https://doi.org/10.1043/0003-3219(1986)056<0007:COCIMI>2.0.CO;2 PubMedGoogle Scholar
- 7.Cordasco G, Matarese G, Rustico L, Fastuca S, Caprioglio A, Lindauer SJ, Nucera R (2014) Efficacy of orthopedic treatment with protraction facemask on skeletal Class III malocclusion: a systematic review and meta-analysis. Orthod Craniofac Res 17(3):133–143. https://doi.org/10.1111/ocr.12040 CrossRefPubMedGoogle Scholar
- 16.Chong Y-H, Ive JC, Årtun J (1996) Changes following the use of protraction headgear for early correction of Class III malocclusion. Angle Orthod 66(5):351–362. https://doi.org/10.1043/0003-3219(1996)066<0351:CFTUOP>2.3.CO;2 PubMedGoogle Scholar
- 21.Higgins JPT, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 the Cochrane collaboration. Available from www.cochranehandbook.org
- 26.Mandall N, Cousley R, DiBiase A, Dyer F, Littlewood S, Mattick R, Nute SJ, Doherty B, Stivaros N, McDowall R, Shargill I, Worthington HV (2016) Early class III protraction facemask treatment reduces the need for orthognathic surgery: a multi-centre, two-arm parallel randomized, controlled trial. J Orthod 43(3):164–175. https://doi.org/10.1080/14653125.2016.1201302 CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Mandall NA, Cousley R, DiBiase A, Dyer F, Littlewood S, Mattick R, Nute S, Doherty B, Stivaros N, McDowall R (2014) Is early class III protraction facemask treatment effective? A multicentre, randomized, controlled trial: 3-year follow-up. J Orthod 39(3):176–185. https://doi.org/10.1179/1465312512Z.00000000028 CrossRefGoogle Scholar
- 28.Pangrazio-Kulbersh V, Berger JL, Janisse FN, Bayirli B (2007) Long-term stability of Class III treatment: rapid palatal expansion and protraction facemask vs LeFort I maxillary advancement osteotomy. Am J Orthod Dentofac Orthop 131(1):7 e9–7 19. https://doi.org/10.1016/j.ajodo.2006.04.024 CrossRefGoogle Scholar
- 39.Schuster G, Lux CJ, Stellzig-Eisenhauer A (2003) Children with Class III malocclusion: development of multivariate statistical models to predict future need for orthognathic surgery. Angle Orthod 73(2):136–145. https://doi.org/10.1043/0003-3219(2003)73<136:CWCIMD>2.0.CO;2 PubMedGoogle Scholar