Long-term evaluation of class 3 orthopedics using skeletal anchorage. Tung Nguyen
Envelope of discrepancy – advent of skeletal anchorage has enlarged the envelope of orthopaedic change possible
Bone Anchored Maxillary Protraction
· 4 plates
o 2 infrazygomatic crest
o 2 between mandibular lateral and canine
· Treatment age 11-14
· 250g force
· Overcorrect
How does it work?
Midface and maxillary protraction DeClerck 2010
· 58% (3.9mm) maxillary protraction
· Midface protraction 2.9mm (Orbitale)
· 42% (2.7mm) mandibular retrained
What took place for correction
· Maxillary protraction via distraction at the maxillary sutures
· Closure of the mandibular angle 2.1 De Clerck
· Distalisation of ramus (3.6mm) )and condyles (2.5mm)
o = bending the condylar angle
Retention protocol
· Wear class 3 elastics to anchors 250 g
· Monitor every 6 months
· Anchors removed same time as 8s removed
Long term BAMP study by Nguyen (not published)
· 15 year follow up of 25 patients
· Outcome CBCT follow up from pre, post and long term
· A point 0.6mm change, vertical 2.1mm
· B point 1.1mm advance, vertical 2.
· Issues
o Mandibular prognathic cases relapsed
16 years of experience
BAMP most effective for:
· Maxillary deficient
· Mild to moderate skeleltal deficiency
· Most effective in younger
· After 15 years of age only retraining effect on mandibible
· 12% failure
