Comparative Evaluation of a Combination of Facemask-Removable Appliance and Removable Appliance Alone for Antero-Posterior Expansion in 8 - 10-Year-Old Cl III Children with Maxillary Deficiency

Objectives: The aim of this study was to evaluate and compare the effects of concomitant use of a facemask and a removable appliance and a removable appliance alone for antero-posterior expansion in Cl III children with maxillary deficiency. Methods: In this retrospective analytical study, 21 Cl III children aged 8 - 10 years were selected using the census sampling technique. The subjects were divided into two groups based on the treatment modality. In group A, the subjects received an antero-posterior-expanding removable appliance and in group B, they received the same removable appliance concomitant with a facemask. Pre- and post-therapeutic cephalograms were analyzed and changes and angles on both images were determined. Mann-Whitney U and Wilcoxon tests were used to compare the results of the two treatment modalities and before-after results respectively (α = 0.05). Results: Wits appraisal, overjet, ANB, U1-SN, U1-PP and A-B difference increased in both groups after treatment (P < 0.05). In the removable appliance group, overbite, SNB and inter-incisal angle decreased (P < 0.05). In the facemask group, IMPA decreased significantly (P < 0.05). Comparison of the two treatment modalities showed that changes in SNA, ANB, overbite, IMPA, U1-SN, U1-PP and inter-incisal angle were significant between the two groups (P < 0.05). Conclusions: Use of a removable appliance alone or in combination with a facemask resulted in the forward movement of point A and protrusion of upper incisors. The removable appliance increased the anterior facial height and decreased overbite. A combination of facemask-removable appliance did not result in the backward and downward rotation of the mandible.