title: Craniofacial changes in patients with Class III malocclusion treated with the RAMPA system.
abstract: OBJECTIVE
  The underlying etiology of Class III malocclusion may be associated with cranial base morphology. The aim of this study is to test the efficacy of a Right-Angled Maxillary Protraction Appliance (RAMPA) System in Asian subjects with Class III malocclusions.
  
  
  METHODS
  27 homologous landmarks were digitized from lateral cephalographs for 10 pre-pubertal Japanese children (mean age 95 months) with skeletal Class III malocclusion prior to and after RAMPA treatment. The mean, pre- and post-treatment craniofacial configurations were computed using Procrustes superimposition, and subjected to principal components analysis (PCA), and finite-element analysis (FEA).
  
  
  RESULTS
  The mean treatment time was 22.5 months. All patients showed significant craniofacial change with correction of anterior and/or posterior crossbite. The mean, pre- and post-treatment craniofacial configurations were statistically different when tested using PCA (p < 0.001), with the first two principal components accounting for 97% of the total shape change. Using FEA, the anterior cranial base showed a relative 12-32% increase in size. The midfacial and mandibular regions, as well as the oropharyngeal airway showed large relative size-changes.
  
  
  CONCLUSIONS
  This study suggests that the anterior cranial base may be targeted in the correction Class III malocclusions.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mitani
authors.forename: Saeed M
authors.initials: SM
authors.lastname: Banabilh
authors.forename: G Dave
authors.initials: GD
authors.lastname: Singh
mesh_terms: D000202:Activator Appliances; D002508:Cephalometry / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005147:Facial Bones / Q000473:pathology*; D005260:Female; D020342:Finite Element Analysis; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D016382:Orthodontic Appliance Design / Q000145:classification; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D023861:Photography, Dental; D012189:Retrospective Studies; D012886:Skull / Q000473:pathology*; D019291:Skull Base / Q000473:pathology; D013314:Stress, Mechanical