Table 2 Characteristics of the included studies
From: Airway dimensional changes following bone anchored maxillary protraction: a systematic review
Author; publication year; journal | Study design; study setting | Sample size(F/M); mean age | Location of anchor; protraction protocol  ± expansion | Assessment method; observation period | Outcome measurements of airway | Results |
|---|---|---|---|---|---|---|
Miranda et al., [10] 2021 Clin Oral Invest | Single centered randomized controlled clinical trial with 2 parallel arms 1:1 allocation ratio Registered | 35 patients; Hybrid Hyrax = 20;(8F, 12 M) Mean age = 10.76yrs Conventional Hyrax = 15; (6F, 9 M) Mean age = 11.52 years | Location: Miniscrews in mandible distal to canines bilaterally Protraction protocol: Class III elastics full time started with 150 g/side in the first month and 250 g/side in the following period changed twice a day in the morning and at night Expansion: HH or CH 1/4 turn twice a day for 14 days, achieving 5.6 mm of expansion Retention Chin cup at night as active retention | - CBCT before Rx (T1) and after Rx (T2) -Surface superimposition and color map -Until a positive overjet is reached or a maximum of 12 months of treatment | -Shape analysis, volume and minimal axial area of airway were performed by 3D Slicer software via the SliceSALT project -Segmentations were performed in the ITK-SNAP software | The oropharynx volume and minimum axial area demonstrated a posttreatment increase in the HH group The oropharynx volume showed similar increases in both groups (MD: − 138.61; 95% CI: − 3078.01, 2800.80) Also, the minimum axial area showed similar increases in both groups (MD: 10.58; 95% CI: − 39.14, 60.30) Both groups showed similar upper airway increases after maxillary protraction |
Beville et al., [36] 2012 Thesis | Prospective clinical study | 30 patients 16 F, 14 M Mean age = 11.1 ± 1.1 yrs | Location: 4 miniplates placed on the right and left infra-zygomatic crest of the maxillary buttress and between the mandibular left and right lateral incisor and canine. Each of the miniplates was secured to bone with 2 or 3 screws Protraction protocol: Three weeks after surgery, Class III elastics were applied with an initial force of 150 g/side, and increased to a final force level of 250 g/side. The patients were instructed to wear the elastics 24 h/day. In some cases, a removable bite plate was used to eliminate occlusal interferences in the incisor area | CBCT 3D cephalometric analysis immediately after placement of miniplates (T1) Mean 1.1 years ± 1 month (T2) | Airway volume and area measurements were done using 3D Dolphin imaging software | Airway volume increased significantly an average of 1411.59 ± 2996.46 mm3 The area in the most constricted section of the airway increased slightly on average 13.11 ± 53.81 mm2, but this increase was not statistically different at T2 compared to T1 |
Nguyen et al., [35] 2015; Angle Orthod | Controlled clinical trial | 10–14 yrs 28 patients (14F,14 M) Mean age = 11.9 yrs 28 controlled (16F 12 M) Mean age = 12.4 yrs | Location: Four miniplates placed, two in the infra-zygomatic crest of the maxillary buttress and two between the mandibular lateral incisors and canines Protraction protocol: Three weeks after surgery, the miniplates were loaded using Class III elastics applied at an initial force of 100 g on each side. The force was increased to 200 g after 1 month of traction and to 250 g after 3 months. The patients were asked to replace the elastics at least once a day and to wear them 24 h per day. In cases with increased overbite, a removable bite plate was inserted in the upper arch to eliminate occlusal interference | CBCT Before initial loading (T1) and after 1 yr (T2) | The airway volumes and minimum cross sectional area measurements were performed using Dolphin Imaging 11.7 3D software | From T1 to T2, airway volume from BAMP-treated subjects showed a statistically significant increase (1499.64 mm3) The area in the most constricted section of the airway (choke point) increased slightly (15.44 mm2) The airway volume of BAMP patients at T2 was 14,136.61 mm3, compared with 14,432.98 mm3 in untreated Class III subjects |
Seo et al., [37] 2017 Maxillofacial Plastic and Reconstructive Surgery | Clinical trial | 28 patients 8 M/ 20 F) were treated with a TBFM Mean age = 10.3 ± 1.4 yrs 24 patients (12 M /12F) were treated with an SAFM Mean age = 11.2 ± 1.1 yrs | Location: Two curvilinear miniplates with 1.5 mm thick Protraction protocol: SAFM Application of the facemask was begun 2 to 3 weeks after the surgery. Patients were asked to wear the face mask all day long and the protraction force of the elastics was adjusted to 400– 500 g on each side Vs TBFM with rapid palatal expansion therapy, in which the first maxillary premolars and first molar were banded with hooks on both sides Patients were instructed to activate the palatal expander one or two times a day until slight overexpansion was obtained. Patients in the TBFM group were asked to wear the face masks for at least 12 h a day. Approximately 400 g of elastic force was applied on each side | Lateral cephalometric before treatment (T1) and after treatment T2 Mean time TBFM = 14.3 months SAFM = 16.9 months | Linear measurement of superior, middle and inferior pharyngeal spaces; Areal measurements of superior, middle and inferior pharyngeal areas using V-ceph software | There were marked increases in upper airway dimensions in both groups following treatment, but the SAFM (skeletal anchored facemask) group had a significantly greater increase in airway dimensions than the TBFM (tooth borne facemask) group Also, the SAFM subgroups showed more improved airway measurements than the TBFM subgroups in both the superior and inferior pharyngeal airways |