Changes in dentofacial morphology in skeletal Class III children treated by a modified maxillary protraction headgear and a chin cup: a longitudinal cephalometric appraisal.

The purpose of the current report was to investigate cephalometrically possible orthopaedic effects of a modified maxillary protraction headgear (MPH) on dentofacial morphology in skeletal Class III female patients before and during the pubertal growth spurt period. Sixty-one patients were divided into three groups, the prepubertal (7-10 years, n = 20), the mid-pubertal (10-12 years, n = 22), and the late pubertal (12-15 years, n = 19) groups. Longitudinal record sets of subjects with acceptable good occlusion were used as the control. Patients were treated by protracting from the upper canine area. The mean ages at completion of the MPH treatment were 8.9, 11.3, and 13.3 years for the three test groups, respectively. The average treatment time was 1.1, 1.0, and 1.4 years for each of these groups. Lateral cephalograms at the start and completion of use of the MPH were collected. Annual differences were calculated from these paired records for each of 21 dentoskeletal variables in the test groups and compared to those of the control group. The pre- and mid-pubertal groups revealed significant increases in both the SNA (P < 0.01 and P < 0.001) and the maxillary length (Ptm-A/PP, P < 0.01), while the late pubertal group showed a less significant increase in the SNA (P < 0.05) alone. The decreased SNB, increased ANB and SNMP of the pre- and mid-pubertal groups was accounted for by the backward and downward rotation of the mandible. The results suggest possible orthopaedic effects of the MPH on dentofacial morphology in young females when it is applied before or during acceleration of the pubertal growth spurt.