Comparison of Protraction Facemask Response Using Banded and Bonded Expansion Appliances as Anchorage

Protraction headgear has been used in combination with various fixed appliances as anchorage to correct Class III malocclusions with maxillary deficiency. The objective of this study was to compare the treatment response of maxillary protraction in combination with either the banded or the bonded rapid palatal expansion appliance. The sample consisted of pre- and posttreatment cephalometric radiographs of 20 patients treated with the banded expansion appliance, 20 patients treated with the bonded expansion appliance, and 20 control patients with no treatment who were matched in sex, age, and skeletal morphology. The average treatment time for the bonded group was 10 ± 2.1 months and the banded group was 9.5 ± 1.9 months. Traditional cephalometric measurements as well as the Pancherz analysis were used to describe the dental and skeletal changes in response to treatment. Data were analyzed using the analysis of variance (ANOVA) and paired t test. There were no significant differences in the forward movement of the maxilla between the banded and bonded expansion groups. The forward movement of the maxilla was 1.0 mm and 1.7 mm greater than in the control group, respectively. The full coverage of the occlusal surface by acrylic did not increase the efficiency of forward maxillary movement. Loss of anchorage was found in both treatment groups. The skeletal and dental contributions to the correction of overjet and overbite were quite similar in the two treatment groups. Maxillary expansion and protraction was accompanied by vertical displacement of the maxilla, increase in lower face height, and vertical eruption of posterior molars, irrespective of the type of anchorage appliance.