Effect of Maxillary Expansion and Protraction in Class III Children on Quality of Life, Dentofacial and Upper Airway Characteristics: A Controlled Clinical Trial.

Abstract

Objective: To explore the relationship between early dentofacial orthopaedic treatment, improvement in the width of oropharynx and nasopharynx, and quality of life.

Materials and methods: Thirty-three prepubertal children with skeletal Class III (median age 9 years; 56% females) received treatment with a maxillary expander and facemask. These subjects were matched with two control groups: one comprising an equal number of untreated Class III individuals, and the other consisting of untreated Class I controls. Cephalograms were analysed, and both children and their parents self-administered the Child Perceptions Questionnaire, Parental-Caregiver Perceptions Questionnaire and Family Impact Scale.

Results: Treated Class III cases showed significant increases in the nasopharyngeal and oropharyngeal airway width (p ≤ 0.033), with greater changes in the nasopharyngeal width compared to untreated Class III cases (p = 0.040). Compared to untreated Class III and Class I groups, treated Class III cases exhibited reduced mandibular prominence and sagittal skeletal Class, increased overjet, overbite, vertical facial dimension, and greater retroclination and retrusion of mandibular incisors (p ≤ 0.011). Prior to and following orthodontic treatment, Class III cases reported a lower quality of life across all dimensions compared to Class I controls (p ≤ 0.032). An increase in maxillary anterior movement and oropharyngeal width correlated with a decrease in functional limitations reported by children (r = -0.411-(-0.413)); (p ≤ 0.022).

Conclusion: Maxillary expansion and protraction in prepubertal Class III children can enhance upper airways width, and children associate these improvements with a reduction in functional limitations.