Postpubertal effects of the rapid maxillary expansion and facial mask versus the removable mandibular retractor for the early treatment of class iii malocclusion: A study on lateral cephalograms

The aim of this study was to compare the efficacy of early treatment of Class III malocclusions with rapid maxillary expansion (RME) and facial mask (FM) versus the removable mandibular retractor (RMR) re-evaluated at a postpubertal observation on lateral cephalograms. All prepubertal patients with Class III malocclusion treated consecutively from 1986 to 2013 by means of RME/FM or RMR were analyzed. Twenty-nine patients treated with RME/FM therapy and 23 patients treated with RMR were selected. Lateral cephalograms were available at 3 time points, before treatment (T1), at the end of active treatment (T2), and at a postpubertal observation (T3). Statistical comparisons were performed with independent sample t tests or Mann–Whitney tests. During the T1–T3 interval, a significantly greater maxillary protraction (SNA +1.5 mm, p = 0.031) and significantly greater improvements in ANB and Wits appraisal (+1.9 degrees, p = 0.002, and +2.2 mm, p = 0.012, respectively) were recorded in the RME/FM group. No statistically significant changes could be found in vertical skeletal measurements. In the dentoalveolar region, the RME/FM group showed a significantly greater correction of the molar relationship (−1.5 mm, p = 0.021). Early treatment of Class III malocclusion with RME/FM protocol in comparison with RMR protocol showed a greater maxillary advancement and greater improvements in sagittal skeletal Class III relationships.