Evaluation of skeletally anchored therapy using miniplates and micro-implants in skeletal Class III treatment

Background/aim: To compare the outcomes of skeletally-anchored (SA) or face mask (FM) therapy in the management of patients presenting with maxillary retrognathia. Methods: Forty-four consecutively treated maxillary retrognathic patients who underwent SA or FM therapies followed by fixed orthodontics were evaluated. Two micro-implants between the maxillary first molar and the second premolar and two mandibular miniplates were inserted to facilitate the use of Class III elastics in the SA group (23 patients). Facemasks with full occlusalcoverage acrylic appliances were applied in the FM group (21 patients). Lateral cephalometric radiographs obtained before treatment (TO), after orthopaedic treatment (T1), and after fixed orthodontic treatment (12) were traced and 31 measurements compared. Results: No statistically significant differences were found between the groups related to treatment duration and gender distribution. The mean age was significantly higher in the SA group (11.70 +/- 0.25 years) compared with the FM group (10.57 +/- 0.35 years) at TO The mean ANB angle increased by 3.34 degrees and 3.15 degrees and the mean Wits value reduced by 6.16 mm and 4.13 mm in the FM and SA groups, respectively. Forward movement of the maxilla was similar between the groups. The vertical plane angle increased in both groups following maxillary protraction. However, it decreased in the SA group during fixed orthodontic therapy, which was contrary to what occurred in the FM group. The lower incisors were retracted/retroclined in the FM group and protracted/proclined in the SA group. Conclusions/implications: Maxillary protraction was achieved in both groups and was maintained during fixed orthodontic therapy. Undesired lower incisor retraction and an increase of the vertical plane angle encountered with FM therapy were minimised by SA therapy.