Class III Treatment with Skeletal and Dental Anchorage: A Review of Comparative Effects

Table 3

Treatment effects in the included studies.

Study	Dentoalveolar effects	Skeletal effects	Soft tissue effetcs	Clinical implications
Aglarci et al. (2016)	Protrusion of the maxillary incisors in theboth groups, but in the FM group maxillary incisors measurements were at least double those of the SA group. Lower incisor retrusion in the FM group, while lower incisor protrusion was observed in the SA group.	Statistically significant increase in sagittal movement of points A and ANS in SA group as compared to FM group. Significant downward and backward rotation of the mandible in both groups, and it was more evident in the FM group. The increase in the occlusal plane angle was more prominent in the FM group.	Improvements in the soft tissue profile were achieved in both groups. Upper lip forward movement was obtained in both treatment groups.	Patients treated with mini- implants and mini-plates exhibited skeletal improvements, with little effect on mandibular position. The undesirable effects associated with FM treatment were eliminated with the SA method.
Cevidanes et al. (2010)	Lower incisor retrusion in the RPE/FM group, while lower incisor protrusion was observed in the BAMP group.	The BAMP protocol induces a significantly larger short-term response in terms of maxillary advancement and changes in midfacial length compared with the RPE/FM protocol. Slight mandibular counterclockwise rotation in BAMP group and clockwise rotation in FM group.	Not reported	The BAMP protocol induces significantly larger maxillary advancement than the RPE/FM therapy. Mandibular sagittal changes are similar, while vertical changes are better controlled with BAMP. Other favorable aspects of BAMP treatment are represented by the lack of clockwise rotation of the mandible and of retroclination of the lower incisors.
Ge et al. (2012)	Lingual inclination of the mandibular incisors was observed in both groups. Significant proclination of maxillary incisors only in the RPE/FM group.	Similar changes in maxillary advancement in both groups.	Improvements in the soft tissue profile were achieved. Upper lip forward movement was obtained in both treatment groups.	Compared with the RPE/FM protocol, the MS/FM therapy produces a similar maxillary advancement. The MS/FM protocol improves skeletal relationships and soft tissue profile and eliminates the undesired proclination of the maxillary incisors and reduces the mesialization of the maxillary dentition, which is present in the RPE/FM therapy.
Hino et al. (2013)	Comparing the 3D displacement of the maxillary incisors in the BAMP and RPE/FM groups, on average, the maxillary incisors were displaced forward by similar amounts.	The mean difference in displacement of the midface between the groups was approximately 1 mm.	Not reported	Orthopedic changes can be obtained with both RPE/FM and BAMP treatments.
Koh et al. (2014)	In the MP/FM group, the angulation of the maxillary incisors was retroclined at CVM3 compared to CVM4	MP/FM group showed closure of the mandibular plane with a high level of significance compared to that of the RPE/FM group. MP/FM produced a significant increase in the antero-posterior position of orbitale (SNOr) and A point.	Not reported	MP/FM produced significant increases in all measured anterior-posterior dimensions. MP/FM in CVM3 resulted in greater anterior-posterior changes, compared to RPE/FM, Statistically significant advantages of the MP/FM group in younger maturity and high vertical skeletal pattern compared with the RPE/FM group.
Lee et al. (2012)	MP/FM therapy induced less labioversion of the maxillary incisors compared with RPE/FM therapy.	The MP/FM group presented with greater forward movement of the maxilla than the RPE/FM group. The RPE/FM group exhibited a greater opening rotation of the mandible than the MP/FM group.	Not reported	MP/FM therapy induced a remarkable advancement of the maxilla, less posterior repositioning and opening rotation of the mandible, and less proclination of the maxillary incisors than RPE/FM therapy.
Ngan et al. (2015)	Greater proclination of the upper incisors in the RPE/FM group compared to the bone-anchored group.	Greater downward movement of the maxilla in the RPE/FM group compared to the bone-anchored group. Mandibular plane angle was found to open significantly more in the RPE/FM compared to the other group.	Not reported	Hybrid Hyrax RPE minimized the side effects encounter by tooth-borne RPE for maxillary protraction such as excessive forward movement of the maxillary molars and incisors, downward movement of the maxilla, and clockwise rotation of the mandible.
Sar et al. (2011)	Retrusion of the maxillary incisors in the MP/FM group and proclination in the FM group. Retrusion of the mandibular incisors in both groups.	Posterior rotation of the mandible in the MP/FM and the FM groups, whereas the rotation in the FM group was more evident. Lower and total facial heights increased in both groups, whereas greater changes were seen in the FM group compared with the MP/FM group. The maxilla advancement was more evident in the MP/FM group than in the FM group.	Improvements in the soft tissue profile in both groups.	The undesired dentoalveolar effects of conventional facemask therapies, such as mesialization and proclination of the maxillary teeth and extrusion of the maxillary molars, were reduced or eliminated with miniplate anchorage placed laterally to the apertura piriformis on both sides of the maxilla.
Tripathi et al. (2016)	Greater proclination of the upper incisors in the FM group compared to the MP/FM group. Slight retroclination of the mandibular incisors in both groups. Mesial movement of the maxillary molars in the FM group.	A greater forward displacement of the maxilla in the MP/FM group compared with the FM group. Downward and backward rotation of the mandible in both groups with more rotation in FM group.	Improvements in the soft tissue profile followed the underlying skeletal components in both groups.	Class III correction by MP/FM has significant skeletal effects with minimal dentoalveolar effects.