The Removable Mandibular Retractor vs the Bone-anchored Intermaxillary Traction in the Correction of skeletal class III Malocclusion in children: A Randomized Controlled Trial.

BACKGROUND No randomized controlled trial has tried to compare early class III treatment outcomes between the removable mandibular retractor (RMR) and the bone-anchored intermaxillary traction (BAIMT). The objective of this study was to evaluate skeletal, dental, and soft-tissue changes following early class III treatment with these two treatment modalities. MATERIALS AND METHODS A parallel group randomized controlled trial was conducted on patients with class III malocclusion, treated at the University ofAl-Baath Dental School in Hamah, Syria. Ninety-three children with skeletal class III malocclusion were evaluated and 41 children fulfilled the inclusion criteria. Randomization was performed using computer-generated tables; allocation was concealed using sequentially numbered opaque and sealed envelopes. Thirty-eight participants were analyzed (mean age 11.46 ± 1.28 years). They were randomly distributed into two groups receiving either the RMR or the BAIMT technique with 19 children in each (1:1 allocation ratio). The primary outcome measure was the horizontal movement of points A, B, and Pogonion. RESULTS Point A showed greater anterior movement in the BAIMT group (x = 1.69 mm) than in the RMR group (x = 1.05 mm; p < 0.001). Points B and Pog showed posterior movement in the BAIMT group (x=-3.01 and -2.51 mm respectively) and anterior movements in the RMR group (x = 0.22 and 0.78 mm respectively). CONCLUSION The BAIMT appeared to be more effective than the RMR in the correction of mild to moderate class III malocclusion in growing patients. CLINICAL SIGNIFICANCE Bone-anchored intermaxillary elastics appears to be a promising solution for class III growing patients with mild to moderate degrees of skeletal discrepancy.