title: The efficacy of Hybrid Hyrax-Mentoplate combination in early Class III treatment: a novel approach and pilot study.
abstract: BACKGROUND
  The aim of the present study was to assess the skeletal, dental and soft tissue effects of a specific treatment protocol in consecutively treated patients who presented with a Class III malocclusion. Treatment involved the use of a Hybrid Hyrax (HH) in the maxilla, a Mentoplate in the mandible and the application of continuous intra-oral Class III elastics.
  
  
  METHODS
  The treated group was comprised of seven males and seven females (mean pretreatment age 10.4 ± 1.7 yr, range 7.8-12.9 yr). Treatment changes were analysed on lateral cephalograms taken 6-12 months prior to commencing treatment (T1) and at the finish of the orthopaedic phase (T2). Where a normality assumption was met, a parametric paired-sample t-test was used to assess the change differences at T1 and T2. For non-normal data, a non-parametric Wilcoxon sign rank test for related samples was used to assess T1 and T2 differences. The level of statistical significance was set at p < 0.05 (2-tailed).
  
  
  RESULTS
  The average sagittal changes showed an improved SNA angle of 2.1 ± 2° (p = 0.002), an ANB angle of 1.9 ± 1.8° (p = 0.002), a Wits improvement of 3.4 ± 2.7 mm (p < 0.001) and an overjet reduction of 2.0 ± 2.2 mm (p = 0.005). There were no statistically significant correlations found between the age at T1, age at treatment start and age at T2 and the changes identified in the cephalometric variables (T2-T1).
  
  
  CONCLUSIONS
  The HH-Mentoplate Class III treatment protocol induced a mean Wits improvement of 3.4 mm in the maxillary and mandibular sagittal base relationship at the functional occlusal level. This was primarily achieved by sagittal maxillary skeletal protraction with negligible effects on the mandible, facial vertical dimension and the incisor angulations. A controlled clinical study with larger sample sizes and longer follow-up times is needed.
authors.forename: Vandana
authors.initials: V
authors.lastname: Katyal
authors.forename: Benedict
authors.initials: B
authors.lastname: Wilmes
authors.forename: Manuel
authors.initials: M
authors.lastname: Nienkemper
authors.forename: M Ali
authors.initials: MA
authors.lastname: Darendeliler
authors.forename: Wayne
authors.initials: W
authors.lastname: Sampson
authors.forename: Dieter
authors.initials: D
authors.lastname: Drescher
mesh_terms: D002508:Cephalometry / Q000379:methods; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000473:pathology; D009295:Nasal Bone / Q000473:pathology; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D057887:Overbite / Q000628:therapy; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D010865:Pilot Projects; D012658:Sella Turcica / Q000473:pathology; D016896:Treatment Outcome; D014716:Vertical Dimension