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Non-compliant maxillary protraction by orthodontic micro-implants

Type:  Articles

Pubblication date:  09/2012

Authors:  L. Favero, A. Winkler, V. Favero

Language:  English

Institution:  Orthodontics, TMJ and DCLM Department Faculty of Medicine and Surgery, Dental School, University of Padova, Italy *Unit of Dentistry and Maxillofacial Surgery, Faculty of Medicine and Surgery, University of Verona, Italy

Publication:  European Journal of Paediatric Dentistry

Publisher:  Ariesdue Srl

Keywords:  Class III correction; Microimplant orthodontics; Non-compliance treatment; Paediatric patients.

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Email:  [email protected]

Title:  Non-compliant maxillary protraction by orthodontic micro-implants

Abstract:  Background Delaire-type facemask is still the appliance of choice for non surgical paediatric Class III treatment. However, it entails great aesthetical problems and is totally dependent on patient compliance. A new modified maxillary protractor was then designed: it is monomaxillary, fixed, implant-supported, aesthetically pleasing and it does not require patient compliance. The aims of this study were to evaluate the clinical use and analyse the effects of a new appliance called Fixed Maxillary Protractor. The device aims at obtaining a forward movement of the maxillary dento-alveolar component in non-compliant paediatric patients, when mandible retrusion cannot be pursued. Case report A non-compliant patient aged 4 years 11 months with mild skeletal and predominant dento-alveolar Class III malocclusion with maxillary deficiency, anterior crossbite and complete deciduous dentition was treated for 10 months. The appliance, anchored by 2 micro-implants in the posterior palatal region, consisted of an acrylic plate, a lingual splint, 2 TMA springs that delivered a posterior-anterior force, 2 anterior security devices and 2 occlusal bite raising splints on the deciduous molars. The treatment yielded a slightly overcorrected Class I incisal relationship. Increase in SNA angle (2) and a decrease in SNB angle (1) resulted in an increase in ANB angle (3). Increases in Wits appraisal of 4 mm and in overjet of 7 mm were obtained. A correction of the anterior crossbite the a posterior sliding of the mandible due to the crossbite correction were observed. An anticlockwise rotation of the maxilla and a mild increase in the anterior facial height were achieved: the treatment effects are similar to those obtained with the Delaire-type facemask, but the amount of postero-anterior correction is lower. Discussion and conclusion The Fixed Maxillary Protractor is effective for the treatment of mild-moderate Class III malocclusion with maxillary deficiency in non-compliant paediatric patients.

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