The Removable Mandibular Retractor vs the Boneanchored 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.