In recent years, incorporating micro-implants (MI) with expansion and protraction devices in various ways, in order to avoid the unwanted dental side effects, resulted in significantly better outcomes.
Age, status of maxillary segments, amount of required maxillary protraction, type of distraction device, vector control, and stability should be carefully considered when surgeons plan cleft maxillary distraction treatments.
This is also in line with those reported by investigators using bone-anchored devices for maxillary protraction [19 21, 27 33].
This is in line with those reported by Wilmes et al. [32, 33] with the Hybrid Hyrax appliance and other investigators that used bone-anchored devices for maxillary protraction [19 21, 27 30].
Tooth movement is one of the major problems in performing maxillary protraction using a tooth-borne RME device [9, 20].
A recent systematic review suggested that maxillary protraction anchored with a bone-anchorage device induces more maxillary advancement with minimal dental side effects when compared with tooth-anchored appliances [17].
Recently, Ngan et al. had reported that in non-cleft class III individuals, the hybrid HYRAX bone-borne expansion device along with maxillary protraction yielded desirable sagittal skeletal change with minimal dental side effects [41].
The aim of this study is to examine the ability of the novel micro-implant-assisted rapid palatal expander (MARPE) and N2 mini-implant to serve as an orthopedic anchorage device in creating favorable maxillary protraction protocols in lieu of the more invasive miniplates.
(A) Sketch of the modified hybrid hyrax device with rigid sectional wire for maxillary protraction in situ.
These temporary anchorage devices (TADs) are useful for various tooth movements, including intrusion, retraction, and protraction.
