Bone-anchored maxillary protraction (BAMP): A review

Mapping the evolving trend of research on Class III malocclusion: a bibliometric analysis

OBJECTIVES

This study aimed to provide visualized knowledge maps to show the evolving trends and key focal points of Class III malocclusion research through a comprehensive bibliometric analysis.

MATERIALS AND METHODS

Class III malocclusion research published between 2000 and 2023 was retrieved from the Web of Science Core Collection. VOSviewer was utilized to count the citation and publication number of authors, institutions, countries and journals. Co-occurrence, co-citation, and cluster analyses and burst detection were conducted using CiteSpace.

RESULTS

A total of 3,682 publications on Class III malocclusion were included in the bibliometric analysis. During 2000-2023, both the annual publication count and citation frequency exhibited a gradual upward trajectory, with a noticeable surge in recent years. In terms of production and citation counts of Class III malocclusion research, the core journal is the American Journal of Orthodontics and Dentofacial Orthopedics. Furthermore, apart from the primary keyword 'Class III malocclusion', 'orthognathic surgery' was identified as keyword with the most frequency. The cluster analysis of cited references reveals that the research focal points have shifted to 'skeletal anchorage' and 'surgery-first approach'. Furthermore, the burst detection identified 'quality of life' as a potential research hotspot since it has recently gained increasing scholarly attention.

CONCLUSIONS

The current study provides scholars with the knowledge maps of evolving trends and prominent topics of Class III malocclusion research and a summary of research progress on various priorities during different periods. These findings are expected to provide a valuable guidance to facilitate the future research on Class III malocclusion.

Comparison of different maxillary advancement protocols in patients with unilateral cleft lip and palate: a finite element analysis

OBJECTIVES

The aim of this study was to evaluate the stress distributions and possible amount of movement in the maxillofacial region resulting from different maxillary advancement protocols in patients with unilateral cleft lip and palate.

MATERIALS AND METHODS

A unilateral cleft lip and palate model (CLP model) with Goslon score 4 was created for finite element analysis. Three different protocols were compared: Group 1: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over a conventional acrylic plate; Group 2: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over miniplates placed in the infrazygomatic crest region; Group 3: usage of elastic from the menton plate placed in the mandible to the infrazygomatic plates in the maxilla.

RESULTS

Dental effects were greater in the maxillary protraction protocol with a face mask over a conventional acrylic plate (Von Misses Stress Values; Group 1?=?cleft side:0.076, non-cleft side:0.077; Group 2?=?cleft side:0.004, non-cleft side: 0.003; Group 3?=?cleft side:0.0025; non-cleft side:0.0015), whereas skeletal effects were greater in maxillary protraction protocols with face mask using skeletal anchorage (Von Misses Stress Values; Group 1:0.008; Group 2:0.02; Group 3:0.0025). The maximum amount of counterclockwise rotation of the maxilla as a result of protraction was observed in traditional acrylic plate face mask protocol, and the minimum amount was observed by using elastics between infrazygomatic plates and menton plate.

CONCLUSIONS

In individuals with unilateral cleft lip and palate with Goslon score 4, it was observed that the skeletally anchored face mask caused more skeletal impact and displacement than both the traditional acrylic plate face mask model and the pure skeletally supported maxillary protraction model.

CLINICAL RELEVANCE

When planning maxillary protraction treatment in patients with cleft lip and palate, it should be considered that more movement in the sagittal plane might be expected on the cleft side than the non-cleft side, and miniplate and screws on the cleft side are exposed to more stress when using infrazygomatic plates as skeletal anchorage.

Maxillary Protraction: A Bibliometric Analysis

OBJECTIVES

The aim of this analysis was to investigate the historical development, current status, and research hot spots related to maxillary protraction in the treatment of maxillary hypoplasia.

METHODS

The term "TS = maxillary protraction" was used to search for articles in the Web of Science Core Collection at the library of Capital Medical University. The results were analysed using CiteSpace6.2.R1 software, including the examination of annual publication trends and analysis of author, country, institution, and keywords.

RESULTS

A total of 483 papers were included in this study. The annual publications showed an overall increasing trend. The top 5 authors with the most published papers were Lorenzo Franchi, Tiziano Baccetti, Seung-Hak Baek, Paola Cozza, and U Hagg. The top 5 countries with the highest publication counts were the US, Turkey, South Korea, Italy, and China. The top 5 institutions in terms of the number of published papers were the University of Florence, the University of Michigan, Kyung Hee University, Seoul National University, and Gazi University. The top 3 journals with the most citations were the American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, and the European Journal of Orthodontics. Furthermore, "Maxillary protraction," "Class III malocclusion," and "Maxillary expansion" were the most common keywords.

CONCLUSIONS

The effective age range for maxillary protraction has been expanded with the introduction of skeletal anchorage and the combination of maxillary expansion and protraction. Skeletal anchorage offers significant advantages over dental anchorage, but there is a need for further research to further substantiate its stability and safety. In recent years, the positive effects of maxillary protraction on the nasopharyngeal area have been well established, but its impact on the oropharyngeal area remains a topic of debate. Therefore, it is crucial to conduct further investigations into the effects of maxillary protraction on the oropharyngeal area and explore the factors that influence different outcomes.

Finite element analysis of sagittal screw expander appliance in the treatment of anterior maxillary hypoplasia

The skeletal anterior crossbite is a common malocclusion in clinic. However, there have been no reports on the maxillary sagittal expansion to correct the premaxillary hypoplasia, which greatly influences the facial morphology and masticatory function, using finite element analysis. In the present study, a three-dimensional finite element model of craniomaxillofacial complex with maxillary sagittal hypoplasia is constructed and the treatment for premaxillary hypoplasia by the sagittal screw expander appliance is simulated. The hypoplasia of the left premaxilla is more serious than that of the right and thus the size of the left part of premaxillary expander baseplate is designed to be larger than that of the right part and the loading is applied at 10° leftward to the sagittal plane and 30° forward and downward to the maxillary occlusal plane. The displacements or equivalent stress distributions of the maxilla, teeth and their periodontal ligaments, are analyzed under the loads of 5.0 N, 10.0 N, 15.0 N, and 20.0 N. Consequently, as the load increases, the displacements or equivalent stresses of the maxilla, teeth and their periodontal ligaments all increase. Almost the whole premaxilla markedly move forward, downward, and leftward while other areas in the craniomaxillofacial complex remain almost static or have little displacement. The equivalent stress concentration zone of the maxilla mainly occurs around and in front of the incisive foramina. The displacements of left premaxilla are generally greater than those of the right under the loading forces. The maximum equivalent stress on the teeth and their periodontal ligaments are 2.34E-02 MPa and 2.98E-03 MPa, respectively. Taken together, the sagittal screw expander appliance can effectively open the premaxillary suture to promote the growth of the premaxilla. An asymmetrical design of sagittal screw expander appliance achieves the asymmetric expansion of the premaxilla to correct the uneven hypoplasia and obtains the more symmetrical aesthetic presentation. This study might provide a solid basis and theoretical guidance for the clinical application of sagittal screw expander appliance in the efficient, accurate, and personalized treatment of premaxillary hypoplasia.