Evaluation of the effect of two types of arch expansion combined with maxillary protraction in the treatment of Class III bony malformations

doi:10.19439/j.sjos.2025.04.017

Abstract

Abstract: PURPOSE: To evaluate the efficacy of rapid maxillary expansion and maxillary alternate rapid expansion combined with maxillary protraction in the treatment of Class III bony malformations. METHODS: A total of 82 patients with skeletal Class III malocclusion admitted to Jiaozhou Central Hospital of Qingdao from May 2021 to April 2024 were selected and divided into two groups according to admission time. The control group (n=40) was treated with simple maxillary rapid arch expansion combined with maxillary protraction. The experimental group (n=42) was treated with maxillary alternate rapid expansion and contraction combined with maxillary protraction, the therapeutic effect of the two groups was compared. RESULTS: Three months after treatment, the Z-angle, H-angle and upper lip angle of the experimental group were significantly higher than those of the control group, and the lower lip inclination was significantly lower than that of the control group(P<0.05). SNA, U1-NA, ANB indexes, maximum occlusal contact area and maximum biting force in the experimental group were significantly higher than those in the control group, while U1-L1 and SNB indexes were significantly lower than those in control group (P<0.05). The masticatory efficiency and oral health impact scale (OHIP-14) scores of the experimental group were significantly higher than those of the control group(P<0.05). CONCLUSIONS: Rapid maxillary expansion combined with maxillary protraction can improve the occlusal function and masticatory efficiency of patients with skeletal Class III malocclusion, and improve the soft and hard tissue indexes of the patients.

Key words: Maxillary protraction, Rapid maxillary expansion, Maxillary alternating rapid expansion and contraction, Skeletal Class III malocclusion

CLC Number:

R783.5

Dong Zuoying, Shang Jinzheng, Sun Yu, Gou Naizheng. Evaluation of the effect of two types of arch expansion combined with maxillary protraction in the treatment of Class III bony malformations[J]. Shanghai Journal of Stomatology, 2025, 34(4): 440-443.

References

[1] Elkalza AR, Yacout YM.Effect of SEC III protocol on upper airway dimensions in growing Class III patients: a retrospective study[J]. BMC Oral Health, 2023, 23(1): 841-851.
[2] Wang J, Yang Y, Wang Y, et al.Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: systematic review and network meta-analysis[J]. Korean J Orthod, 2022, 52(5):313-323.
[3] Kim M, Li J, Kim S, et al.Individualized 3D-printed bone-anchored maxillary protraction device for growth modification in skeletal Class III malocclusion[J]. J Pers Med, 2021, 11(11):1087.
[4] Buyukcavus MH, Kale B, Aydemir B.Comparison of treatment effects of different maxillary protraction methods in skeletal Class III patients[J]. Orthod Craniofac Res, 2020, 23(4):445-454.
[5] 李超, 姜欢, 宋东升, 等. 上颌交替快速扩缩治疗骨性Ⅲ类患者的研究进展[J].中华口腔正畸学杂志, 2023, 30(4): 225-228.
[6] 张志愿. 口腔科学[M]. 9版. 北京: 人民卫生出版社, 2018: 79-82.
[7] Serrano J, López-Pintor RM, Fernández-Castro M, et al.Usefulness of implementing the OHIP-14 questionnaire to assess the impact of xerostomia and hyposalivation on quality of life in patients with primary Sjögren's syndrome[J]. J Oral Pathol Med, 2022, 51(9): 810-817.
[8] Rizk MZ, Torgersbråten N, Mohammed H, et al.Stability of single-jaw vs two-jaw surgery following the correction of skeletal Class III malocclusion: a systematic review and meta-analysis[J]. Orthod Craniofac Res, 2021, 24(3):314-327.
[9] Ventura L, Verdonk SJE, Zhytnik L, et al.Dental abnormalities in osteogenesis imperfecta: a systematic review[J]. Calcif Tissue Int, 2024, 115(5): 461-479.
[10] Alshehri A.Bimaxillary distalization with skeletal anchorage for management of severe skeletal Class III open bite malocclusion[J]. Children (Basel), 2022, 9(11):1666.
[11] 赵飘, 陈泽策, 廖成成, 等. 前方牵引治疗的不同方式及比较[J]. 北京口腔医学, 2023, 31(3): 225-228.
[12] 于晓艳, 郅晓雷, 张耐新, 等. 前方牵引联合快速扩弓治疗替牙期骨性Ⅲ类错𬌗畸形的疗效分析[J]. 现代口腔医学杂志, 2020, 34(2): 104-106.
[13] Srivastava SC, Mahida K, Agarwal C, et al.Longitudinal stability of rapid and slow maxillary expansion: a systematic review[J]. J Contemp Dent Pract, 2020, 21(9):1068-1072.
[14] Chamberland S.Maxillary expansion in nongrowing patients. Conventional, surgical, or miniscrew-assisted, an update[J]. J World Fed Orthod, 2023, 12(4):173-183.
[15] Patil GV, Lakhe P, Niranjane P.Maxillary expansion and its effects on circummaxillary structures: a review[J]. Cureus, 2023, 15(1):e33755.
[16] Cornelis MA, Tepedino M, Riis NV, et al.Treatment effect of bone-anchored maxillary protraction in growing patients compared to controls: a systematic review with meta-analysis[J]. Eur J Orthod, 2021, 43(1):51-68.
[17] 刘晔, 葛晓磊, 张士珑, 等. 改良前方牵引矫治器治疗骨性Ⅲ类错𬌗伴拥挤的疗效评价[J]. 上海口腔医学, 2024, 33(2): 180-185.
[18] 杨圣仙. 2种不同前牵引在骨性Ⅲ类错𬌗畸形治疗中的疗效分析[J]. 现代医学与健康研究电子杂志, 2019, 3(23): 45-46.
[19] Emek Kayafoglu G, Esenlik E.Comparison of rapid maxillary expansion and alternate rapid maxillary expansion and constriction protocols with face mask therapy[J]. Turk J Orthod, 2023, 36(4):231-238.
[20] Lee WC, Shieh YS, Liao YF, et al.Long-term maxillary anteroposterior changes following maxillary protraction with or without expansion: a meta-analysis and meta-regression[J]. PLoS One, 2021, 16(2):e0247027.
[21] 郭靖晗, 郭姜莉, 王可鑫, 等. 前方牵引对骨性Ⅲ类口呼吸儿童面型及上气道的影响[J]. 临床口腔医学杂志, 2024, 40(3): 151-155.