Korean J Orthod.  2023 Jan;53(1):35-44. 10.4041/kjod22.117.

Does surgically assisted maxillary protraction with skeletal anchorage and Class III elastics affect the pharyngeal airway? A retrospective, long-term study

• Ozbilen EO
• Papaefthymiou P
• Yilmaz HN
• Küçükkeleş N

• KMID: 2538711
• DOI: http://doi.org/10.4041/kjod22.117

Abstract

Objective
Surgically assisted maxillary protraction is an alternative protocol in severe Class III cases or after the adolescent growth spurt involving increased maxillary advancement. Correction of the maxillary deficiency has been suggested to improve pharyngeal airway dimensions. Therefore, this retrospective study aimed to analyze the airway changes cephalometrically following surgically assisted maxillary protraction with skeletal anchorage and Class III elastics.
Methods
The study population consisted of 15 Class III patients treated with surgically assisted maxillary protraction combined with skeletal anchorage and Class III elastics (mean age: 12.9 ± 1.2 years). Growth changes were initially assessed for a mean of 5.5 ± 1.6 months prior to treatment. Airway and skeletal changes in the control (T0), pre-protraction (T1), post-protraction (T2), and follow-up (T3) periods were monitored and compared using lateral cephalometric radiographs. Statistical significance was set at p < 0.05.
Results
The skeletal or airway parameters showed no statistically significant changes during the control period. Sella to nasion angle, N perpendicular to A, Point A to Point B angle, and Frankfort plane to mandibular plane angle increased significantly during the maxillary protraction period (p < 0.05), but no significant changes were observed in airway parameters (p > 0.05). No statistically significant changes were observed in the airway parameters in the follow-up period either. However, Sella to Gonion distance increased significantly (p < 0.05) during the follow-up period.
Conclusions
No significant changes in pharyngeal airway parameters were found during the control, maxillary protraction, and follow-up periods. Moreover, the significant increases in the skeletal parameters during maxillary protraction were maintained in the long-term.

Keyword

Class III treatment; Airway; Maxillary protraction; Surgical assistance

Figure

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  Figure 1 A, The occlusal view of the appliance. B, Intraoral elastic usage.

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  Figure 2 Skeletal measurements. 1, SNA (°); 2, SNB (°); 3, ANB (°); 4, FMA (°); 5, RP1; 6, RP1-PNS (mm); 7, RP1-A (mm); 8, S-Go (mm); 9, N⊥A (mm). See Table 2 for definition of the planes and the measurements.

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  Figure 3 Pharyngeal airway measurements (mm). 10, Ad1-PNS; 11, Ad2-PNS; 12, PAS; 13, SPAS; 14, MAS; 15, IAS; 16, EAS. See Table 2 for definition of the planes and the measurements.

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  Figure 4 Boxplots of the airway parameters during maxillary protraction period (T2–T1). T1, pre-protraction, before cementation of the acrylic splint; T2, post-protraction, after debonding of the acrylic splint. See Table 2 for definition of the planes and the measurements.

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