The effect of maxillary protraction therapy on skeletal classⅢ malocclusion with two different methods of rapid maxillary expansion

doi:10.3877/cma.j.issn.1674-1366.2017.03.007

Abstract

Abstract:

Objective

To compare the effects of maxillary protraction therapy in skeletal classⅢ malocclusion with alternate rapid maxillary expansion and constriction (Alt-RAMEC/FM) and with rapid maxillary expansion (RME/FM) .

Methods

Twenty cases of maxillary deficiency in skeletal classⅢmalocclusion patients were divided into two groups according to the types of expansion, cephalometric images and the corresponding measurements were taken before and after the treatment. The data of two groups before and after treatment were tested with paired sample t test, and the change of the quantity of each item before and after the test of the two groups was performed with independent sample t test by SPSS 19.0 software.

Results

After the treatment, patients of two groups had obvious maxillary advancement and mandibular retrusion, including simple expansion group SNA increased by (3.18 ± 1.92) °, SNB decreased by (2.73 ± 0.82) °, ANB increased by (3.94 ± 0.85) °, A-VL increased by (3.53 ± 2.29) mm, B-VL decreased by (3.31 ± 2.71) mm; and repeatedly expansion group SNA increased by (4.85 ± 1.38) °, SNB decreased by (2.49 ± 0.65) °, ANB increased by (4.94 ± 1.07) °, A-VL increased by (6.39 ± 3.15) mm, B-VL decreased by (3.93 ± 1.95) mm, The anterior teeth labially proclined with the increase of the mandibular plane angle, the two groups of U1-SN increased by (3.97±2.46) ° and (4.07±1.68) ° respectively, the MP-SN increased by (3.81 ± 2.21) ° and (3.51 ± 1.34) °. The SNA (t= 2.233, P= 0.038) , ANB (t= 2.314, P= 0.033) and Wit (t= 3.474, P= 0003) of the repeated expansion group were significantly higher than that of the simple rapid expansion group. No significant differences were found in other indicators.

Conclusions

In skeletal classⅢ patients, the Alt-RAMEC/FM protocol can induce more favorable maxillary advancement effects and a greater improvement in sagittal skeletal relationships as compared to the conventional RME/FM protocol, but it cannot reduce the clockwise rotation of mandibular and decrease the inclination of upper and lower incisors.

Key words: Orthodontic traction, Palatal expansion technique, Maxillary retrusion, Maxillary protraction

Zaidao Xiong, Jie Ke, Guizhi Zhao, Qinghua Lin, Xingming Yang, Yihan Xiao. The effect of maxillary protraction therapy on skeletal classⅢ malocclusion with two different methods of rapid maxillary expansion[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2017, 11(03): 169-173.

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Figures/Tables 5

References 16

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测量项目	A组(n = 10)		t值	P值	B组(n = 10)		t值	P值
测量项目	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
SNA（°）	78.19 ± 4.42	81.37 ± 3.48	1.787	0.035^a	78.73 ± 3.06	83.58 ± 3.82	3.134	0.006^a
SNB（°）	82.68 ± 2.42	79.95 ± 3.55	2.001	0.029^a	81.66 ± 2.95	79.17 ± 2.26	2.118	0.024^a
ANB（°）	-2.73 ± 1.67	1.21 ± 1.02	6.367	0.000^a	-3.29 ± 2.07	1.65 ± 1.28	6.419	0.000^a
MP-SN（°）	33.08 ± 3.23	36.89 ± 5.18	1.970	0.032^a	34.64 ± 4.05	38.15 ± 3.64	2.038	0.028^a
SN-PP（°）	10.57 ± 2.57	11.29 ± 2.58	0.625	0.269	8.92 ± 4.22	9.48 ± 3.91	0.309	0.381
U1-SN（°）	106.35 ± 4.19	110.62 ± 3.83	2.389	0.014^a	109.89 ± 5.67	113.96 ± 4.17	1.829	0.042^a
L1-MP（°）	87.84 ± 7.55	84.10 ± 6.76	1.167	0.129	86.55 ± 7.47	83.26 ± 7.85	0.960	0.175
Wit值(mm)	-8.10 ± 3.51	-5.44 ± 2.49	1.955	0.033^a	-10.33 ± 3.63	-4.71 ± 3.57	3.491	0.001^a
A-VL(mm)	46.54 ± 3.26	50.07 ± 4.84	1.913	0.036^a	45.23 ± 2.27	51.62 ± 4.21	4.225	0.000^a
B-VL(mm)	57.47 ± 3.79	54.16 ± 4.33	1.819	0.043^a	59.04 ± 4.16	55.11 ± 3.58	2.264	0.018^a
Sn-VL(mm)	58.64 ± 4.43	62.19 ± 3.26	2.041	0.028^a	57.43 ± 6.21	63.28 ± 4.29	2.451	0.012^a
Si-VL(mm)	62.61 ± 8.15	60.37 ± 5.61	0.716	0.212	67.78 ± 7.38	64.43 ± 6.19	1.099	0.143

测量项目	A组(n = 10)		t值	P值	B组(n = 10)		t值	P值
测量项目	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
SNA（°）	78.19 ± 4.42	81.37 ± 3.48	1.787	0.035^a	78.73 ± 3.06	83.58 ± 3.82	3.134	0.006^a
SNB（°）	82.68 ± 2.42	79.95 ± 3.55	2.001	0.029^a	81.66 ± 2.95	79.17 ± 2.26	2.118	0.024^a
ANB（°）	-2.73 ± 1.67	1.21 ± 1.02	6.367	0.000^a	-3.29 ± 2.07	1.65 ± 1.28	6.419	0.000^a
MP-SN（°）	33.08 ± 3.23	36.89 ± 5.18	1.970	0.032^a	34.64 ± 4.05	38.15 ± 3.64	2.038	0.028^a
SN-PP（°）	10.57 ± 2.57	11.29 ± 2.58	0.625	0.269	8.92 ± 4.22	9.48 ± 3.91	0.309	0.381
U1-SN（°）	106.35 ± 4.19	110.62 ± 3.83	2.389	0.014^a	109.89 ± 5.67	113.96 ± 4.17	1.829	0.042^a
L1-MP（°）	87.84 ± 7.55	84.10 ± 6.76	1.167	0.129	86.55 ± 7.47	83.26 ± 7.85	0.960	0.175
Wit值(mm)	-8.10 ± 3.51	-5.44 ± 2.49	1.955	0.033^a	-10.33 ± 3.63	-4.71 ± 3.57	3.491	0.001^a
A-VL(mm)	46.54 ± 3.26	50.07 ± 4.84	1.913	0.036^a	45.23 ± 2.27	51.62 ± 4.21	4.225	0.000^a
B-VL(mm)	57.47 ± 3.79	54.16 ± 4.33	1.819	0.043^a	59.04 ± 4.16	55.11 ± 3.58	2.264	0.018^a
Sn-VL(mm)	58.64 ± 4.43	62.19 ± 3.26	2.041	0.028^a	57.43 ± 6.21	63.28 ± 4.29	2.451	0.012^a
Si-VL(mm)	62.61 ± 8.15	60.37 ± 5.61	0.716	0.212	67.78 ± 7.38	64.43 ± 6.19	1.099	0.143

测量项目	A组(n = 10)	B组(n = 10)	t值	P值
SNA（°）	3.18 ± 1.92	4.85 ± 1.38	2.233	0.038^a
SNB（°）	-2.73 ± 0.82	-2.49 ± 0.65	0.725	0.478
ANB（°）	3.94 ± 0.85	4.94 ± 1.07	2.314	0.033^a
MP-SN（°）	3.81 ± 2.21	3.51 ± 1.34	0.367	0.718
SN-PP（°）	0.72 ± 0.48	0.56 ± 0.32	0.877	0.392
U1-SN（°）	3.97 ± 2.46	4.07 ± 1.68	0.106	0.917
L1-MP（°）	-3.74 ± 2.19	-3.29 ± 1.23	0.565	0.578
Wit值(mm)	2.66 ± 1.42	5.62 ± 2.29	3.474	0.003^a
A-VL(mm)	3.53 ± 2.29	6.39 ± 3.15	2.322	0.032^a
B-VL(mm)	-3.31 ± 2.71	-3.93 ± 1.95	0.587	0.564
Sn-VL(mm)	3.55 ± 3.27	5.85 ± 3.03	1.631	0.120
Si-VL(mm)	-2.24 ± 1.21	-3.35 ± 2.33	1.337	0.198

测量项目	A组(n = 10)	B组(n = 10)	t值	P值
SNA（°）	3.18 ± 1.92	4.85 ± 1.38	2.233	0.038^a
SNB（°）	-2.73 ± 0.82	-2.49 ± 0.65	0.725	0.478
ANB（°）	3.94 ± 0.85	4.94 ± 1.07	2.314	0.033^a
MP-SN（°）	3.81 ± 2.21	3.51 ± 1.34	0.367	0.718
SN-PP（°）	0.72 ± 0.48	0.56 ± 0.32	0.877	0.392
U1-SN（°）	3.97 ± 2.46	4.07 ± 1.68	0.106	0.917
L1-MP（°）	-3.74 ± 2.19	-3.29 ± 1.23	0.565	0.578
Wit值(mm)	2.66 ± 1.42	5.62 ± 2.29	3.474	0.003^a
A-VL(mm)	3.53 ± 2.29	6.39 ± 3.15	2.322	0.032^a
B-VL(mm)	-3.31 ± 2.71	-3.93 ± 1.95	0.587	0.564
Sn-VL(mm)	3.55 ± 3.27	5.85 ± 3.03	1.631	0.120
Si-VL(mm)	-2.24 ± 1.21	-3.35 ± 2.33	1.337	0.198

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