Palatal versus buccal protraction using plates assisted with facemask in growing Class III patients: A randomized clinical trial.

Background: This study aimed to compare palatal versus buccal protraction using plates assisted with a facemask in growing Class III patients.

Methods: Twenty growing Class III patients were randomly allocated into two main groups. In Group 1, a surgical mini-plate was bent into a semicircular shape and adapted to the patient's model to extend from the canine area on one side to the contralateral canine area. The adapted mini-plate was placed on the palate immediately posterior to the palatal rugae. Four self-drilling surgical mini-screws were installed with an angulation of 60°-70° to the long axis of the teeth. In Group 2, a surgical mini-plate was bent and placed in the zygomatic buttress area, according to the anatomy of the region, and fixed with screws. The end of the mini-plate was exposed over the keratinized attached gingiva near the canine, and the end holes were modified to create a hook for elastics. Mucoperiosteal flaps were repositioned and sutured. For both groups, pretreatment and post-treatment cephalometric radiographs were analyzed to evaluate maxillary protraction and dentoskeletal changes.

Results: A statistically significant difference was found when comparing treatment periods in both groups, with Group 1 showing a shorter treatment duration (P<0.05). Comparison of cephalometric measurements between pre- and post-treatment revealed statistically significant differences in both angular and linear dimensions (P<0.05).

Conclusions: Both skeletal anchorage protocols for maxillary protraction effectively resolved the severe maxillary deficiency in growing Class III patients.