Three Dimensional Evaluation of Skeletal Effects of Two Non- Compliance Appliances in the Treatment of Growing Skeletal Class Iii Patients (a Randomized Controlled Clinical Trial)

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Abstract Objective Study was conducted to 3D evaluate skeletal effects of two different intraoral force application systems for treating skeletally growing ClassIII patients(RCT). Material and Methods 33 patients recruited and randomly allocated between three groups: GroupI(n = 11)treated with CS2000(CSgroup/ pulling force), GroupII(n = 11)treated with reversed Forsus Fatigue Resistant(RFgroup/ pushing force) and GroupIII(n = 11)untreated control(negative control). A CBCT taken before treatment(T0) and after gaining a 2mm overjet or after observation period of 6months(T1). Skeletal measurements were assessed and compared between groups. Within group comparisons were done using Wilcoxon Sign Rank test. Results Sagittaly in RFgroup, OLp-Apt increased by3.60mm, OLp-Bpt decreased by-2.50mm and OLp-Pg decreased as well by-2.00mm(P < 0.0001). In the same sagittal dimension for CSgroup, OLp-Apt increased by3.10mm, OLp-Bpt decreased by-1.10mm and OLp-Pg decreased as well by-1.00mm. Wits appraisal was increased by5.00mm and5.50mm in RF and CSgroup accordingly(P < 0.0001). There was an increase in OLs-Apt in treatment groups by3.80mm in RFgroup and5.00mm in CSgroup(P < 0.0001). Vertically there was a statistical significant difference between two groups. The ANS-Me decreased in RFgroup by-0.70mm and increased in CSgroup by2.00mm. Both treatment groups demonstrated an increase in SNAangle(2.6°in RFgroup and2.5° in CSgroup), decrease in SNBangle − 1.00°in RFgroup and-2.00°in CSgroup, hence increase in ANBangle.(P < 0.0001) Conclusions CS2000 spring and reversed Forsus Fatigue Resistance device promoted forward maxillary advancement in average of 5months. Both appliances gave close effects to bone anchored maxillary protraction devices and functional appliances, removing compliance factor out of the equation. Clinical relevance: Short term correction of growing skeletal class III using either one of novel techniques give positive skeletal results. Trial registration: Registered in clinicaltrial.gov (NCT04825951) in 01/04/2019, taking the approval of institutional review board at the Faculty of Dentistry, Alexandria University protocol record 070320212.

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