Effects of treatment with a combined maxillary protraction and chincap appliance in skeletal Class III patients with different vertical skeletal morphologies

Several cephalometric studies and case reports have described the effects of treatment with a maxillary protraction appliance (MPA) and chincap appliance. The purpose of this investigation was to identify differences in the response to treatment with a combined MPA and chincap in skeletal Class III patients with different vertical skeletal morphologies: short- (low mandibular plane angle) and long- (high mandibular plane angle) face types. The cephalograms used in this study were of 42 Japanese girls at the beginning of treatment (T0, mean age 10.1 years) and at removal of the appliance (T1, mean age 11.5 years). The subjects were divided into two groups (short and long face) according to the inclination of the mandibular plane at T0.Total anterior face height, upper and lower face height, occlusal plane, and gonial angle were significantly larger in the long-face group at T0. In both groups, significant increases in SNA, maxillary size (A′-Ptm′), and ANB were noted during treatment. Compared with the long-face group, the short-face group showed greater forward displacement and size increment of the maxillary body, while there were no significant differences in changes in mandibular size or position between the two groups. These results indicate that the vertical dimensions of the craniofacial skeleton are important factors in the orthopaedic effects of a MPA and chincap and the prognosis for skeletal Class III patients.