A comparative evaluation of skeletal and dentoalveolar effects of akkaya vertical protraction appliance and reverse headgear

The aim of this randomized clinical study is to evaluate the skeletal and dentoalveolar effects of Akkaya Vertical Protraction Appliance(AVPA) which is developed to prevent the undesired side effects of conventional protraction therapy and for providing simultaneous openbite and maxillary deficiency caused skeletal Class III treatment in patients with increased or optimum vertical dimentions, in comparison with reverse headgear(RH).The inclusion criteria for the randomizedly selected 30 patients(average age:10.19 years) to the AVPA group were the presence of maxillary deficiency caused skeletal Class III, increased or normal vertical dimentions and being at the pubertal growth spurt or earlier growth periods. RH group consisted randomizely selected 30 patients(average age10.81 years) from archive records.Inter- and intragroup differences were analyzed with independent and paired samples t-tests.As a result of AVPA treatment palatal plane inclination remained stable whereas it decreased significantly in RH group. Gonial,ramal and mandibular plane angles decreased significantly in AVPA group ,however,significant increase was observed in RH group. As a result of maxillary anterior and mandibulary posterior rotation observed in RH group,lower anterior face height increased significantly as compared to AVPA group.Upper maxillary incisor extrusion and protrusion was recorded in both groups and as for the lower incisors, protrusion was recorded in AVPA group whereas retrusion was recorded in RH group. The amount of mesialisations were found to be similiar in both groups and increase in vertical dimentions of upper and lower molars were recorded to be less in AVPA group as a result of vertically directed forces.With the implementation of AVPA, vertical control was successfully achieved while preventing the maxillary and mandibular side effects of the conventional protraction treatment. For the prevention of dentoalveolar side effects, the use of skeletal anchorage with AVPA can be considered.