• The Journal of the Korean dental association
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• v.55 no.12
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• pp.870-882
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• 2017

Maxillary growth is hindered by the restricting pressure from the scar tissue formed after lip closure and palate closure surgeries of the cleft. Therefore, the anteroposterior skeletal relationship of both jaws exacerbates as patient grows. Conventional facemask treatment is valuable for dentoalveolar compensatory treatment and for very mild maxillary hypoplasia. To achieve further maxillary protraction, bone-anchored facemask or bone-anchored maxillary protraction can be attempted. For moderate maxillary hypoplasia, surgical orthodontic treatment after growth completion can be an efficient treatment reducing uncontrollable problems. For moderate to severe maxillary hypoplasia, distraction osteogenesis (DO) can be used alone or with later surgical orthodontic treatment. To compensate the severe relapse after DO, overcorrection and bone plate placement after DO are recommended. In case of hypernasality, maxillary anterior segmental distraction osteogenesis can be chosen to prevent exacerbation of the hypernasality.

• 대한치과교정학회:학술대회논문집
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• 2000.11a
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• pp.36.1-36.1
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• 2000

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.604-612
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• 1998

The majority of Class III malocclusion have maxillary retrusion. Thus, it becomes obvious that management of most skeletal Class III malocclusion cases should include maxillary protraction as major objective. Additionally, in Class III malocclusion with posterior crossbite, RME "disarticulates" the maxilla and initiates cellular response in the sutures, allowing a more positive reaction to protraction forces. Using facemask with RME helped in correction of skeletal Class III malocclusion by the anterior displacement of maxilla and maxillary dentition, and changing the direction of the growth of mandible. Thus, acceptable improvement in the Class III profile was performed.

• The korean journal of orthodontics
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• v.27 no.6 s.65
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• pp.997-1004
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• 1997

The clinical cases presented here involve skeletal Class III malocclusion cases treated with maxillary protraction in a relatively short period of time with good results. When used on young patients, satisfactory results were obtained in a short period of time, but even for those with less growth potential remaining, skeletal enhancement was still evident. However, data on the criteria of diagnosis or relapse following maxillary protraction is limited despite the number of studies on the subject. The present study could not include the observations on retention and relapse, and further studies in the future nay include such observations.

• The korean journal of orthodontics
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• v.53 no.1
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• pp.54-64
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• 2023

This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (AltRAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.

• The korean journal of orthodontics
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• v.32 no.6 s.95
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• pp.413-424
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• 2002

Preadolescent children with deficient maxillae are suitable candidates for the maxillary protraction appliance(MPA). The theoretical effect of the MPA is protraction or anterior displacement of the maxilla. However, it is known that complex effects such as anterior displacement of the maxillary teeth, downward and backward rotation of the mandible, linguoversion of the mandibular anterior incisors, are known to play a role in improving the Cl III malocclusion. There have been much studies with regard to maxillary protraction, but the different effects of MPAs depending on the vertical facial pattern are not known precisely. This study was based on 67 patients (31 males, 36 females) aged from 6 years 6 months to 13 years 3months, who visited the Dept. of Orthodontics at Yonsei Univ., Dental Hospital and diagnosed as skeletal Class III with maxillary deficiency. They were divided into 3 groups (low, average, high angle groups) depending on genial angle and the SNMP (Go-Gn) angle, respectively. Pretreatment and post-treatment lateral cephalograms were used to compare the effects of MPA and the following conclusions were obtained: 1) A significantly large amount of backward movement of the B point was observed in patients with a low SNMP angle. Those with a high SNMP angle had significant forward movement at A point. 2) The patients with low genial angle had the least forward movement at the A point, and those with a high angle had more forward movement. 3) In comparing the arcTan of the A point, the high angle group showed more horizontal movement while the low angle group showed more vertical movement. 4) There was no significance between the treatment duration of the SNMP and the Genial angle groups.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.4
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• pp.359-371
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• 2007

Recently, many studies were reported accurate analysis of facemask effect due to the development of the personal computers and computer programs. The aim of this study is appropriate protraction direction of facemask using finite element study with computer aided design and computer aided measurement. The construction of the three dimensional FEM was based on the computer tomography(CT) scans of 13.5 year-old male subject. Protraction force of 500 mg was applied at 0, 30, 60 and 90 degrees downwards to the Frankfort horizontal plane, and maxillary displacement and stress distribution were measured. When 60 degree force was applied, it showed forward movement of premolar roots area and downward movement of anterior nasomaxillary area, and others showed clockwise rotation movement of the nasomaxillary complex. Finally, we can produce the protraction of maxillary bone without rotation of maxilla about 60 degrees.

• The korean journal of orthodontics
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• v.27 no.3 s.62
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• pp.373-389
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• 1997

The purpose of this stdudy was to evaluate the effect of maxillary protraction and the relapse of hard and soft tissue after maxillary protraction. For this study 29 patients who were treated with maxillary protractor and labiolingual archwire were selected. Their mean age was 9 years 4 months and mean treatment period was 8.5 months. Lateral cephalograms were taken at pretreatment, immediately after treatment and one to three months after removal of the maxillary protractor. They were traced on skeletodental and soft tissue structures based on Burstone's analysis and analyzed by Quick-Ceph Image Digitizing System(ORTHODONTIC PROCESSING). The mean and standard deviation between pretreatment and posttreatment and between posttreatment and retention period for each cephalometric variable were calculated. Student t-test was used to determine the statistical significance of the changes in each variable. Correlation coefficients between hard tissue and soft tissue were used to determine interrelationship. The results were as follows. 1. After maxillayy protraction, the maxilla and maxillary dentition moved antero-inferiorly, the mandibld and mandibular dentition moved postero-interiorly and palatal plane rotated antero-superiorly by $0.59^{\circ}$. 2. After maxillary protraction, the soft tissue of upper lip moved antero-interiorly with the movement of hard tissue but the antero-posterior position of lower lip was stable in spite of the change of hard tissue. The thickness of upper lip was decreased and that of lower lip was increased after maxillary Protraction. 3. During the retention period, the position of jaws was relatively stable but upper and lower anterior teeth and antero-superiorly rotated palatal plane relapsed to original position. 4. During the retention period, the soft tissue of lips was stable antero-posteriorly and moved mote inferiorly than posttreatment. 5. The correlation coefficients between the postion of upper and lower incisal edge and that position of lips were high, especially in horizontal change.

• The Journal of the Korean dental association
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• v.57 no.11
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• pp.654-663
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• 2019

This case report describes the management of a 30-year-old woman with hopeless mandibular first molars and right maxillary second premolar. The treatment plan included mandibular second and third molar protraction after extraction of mandibular first molars. Mini-implants were placed between roots of first and second premolar. Sliding mechanics with lever arm was used to prevent inclination of molars. A good functional occlusion was achieved in 38 months without clinically significant side effects. Most of the extraction space of mandibular first molar was closed by protraction of second and third molars. The skeletal Class II pattern was improved by counterclockwise rotation of mandible through reduction of wedge effect. Mandibular molar protraction with orthodontic mini-implants in adequate cases would be a great alternative to prosthetic implant and reduce the financial and surgical burden of patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.20.1-20.6
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• 2016

Background: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. Case presentation: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. Conclusions: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.