{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:33:13Z","timestamp":1780475593768,"version":"3.54.1"},"reference-count":46,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study evaluated the long-term stability of maxillary protraction (MP) in patients with complete unilateral cleft lip and palate (UCLP) and identified factors influencing relapse and long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Twenty-three adolescents with UCLP who underwent MP therapy were recalled when craniofacial growth was close to completion. Subjects exhibiting reverse\/positive overjets were assigned to unstable\/stable groups. Lateral cephalometric measurements were made before treatment (T0), after active treatment (T1), and at the end of the growth spurt (T2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      About 63% of the subjects exhibited positive overjets during follow-up. The unstable group demonstrated higher B\u2013x and Co\u2013Gn distances than the stable group (both\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05) at T0. More short-term (T0\u2013T1) sagittal advancement of point A (A\u2013y) was evident in the unstable group than in the stable group (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05), but no long-term difference was apparent between the two groups (\n                      <jats:italic>P<\/jats:italic>\n                      = .481). During the posttreatment period (T1\u2013T2), the SNA angle and maxillary incisor protrusion (U1\u2013SN angle) were considerably lower in the unstable group than in the stable group (both\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). Overall, the unstable group exhibited a lower increase in the vertical extent of point A (A\u2013x) than the stable group from T0 to T2 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In the long term, MP affords favorable maxillary advancement in patients with UCLP. A mandibular excess at T0 and vertical maxillary hypoplasia may contribute to the long-term relapse of a reverse overjet.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/070418-501.1","type":"journal-article","created":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T07:42:37Z","timestamp":1543390957000},"page":"214-220","source":"Crossref","is-referenced-by-count":10,"title":["Long-term stability of maxillary protraction therapy in Class III patients with complete unilateral cleft lip and palate"],"prefix":"10.2319","volume":"89","author":[{"given":"Yixin","family":"Zhang","sequence":"first","affiliation":[{"name":"PhD candidate, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Fu","sequence":"additional","affiliation":[{"name":"Attending Doctor, Department of Orthodontics, Affiliated Hospital of Stomatology, School of Medicine, Zhejiang University, Hangzhou, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haichao","family":"Jia","sequence":"additional","affiliation":[{"name":"Clinical Professor, Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiping","family":"Huang","sequence":"additional","affiliation":[{"name":"Resident, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobei","family":"Li","sequence":"additional","affiliation":[{"name":"Graduate student, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Graduate student, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiran","family":"Li","sequence":"additional","affiliation":[{"name":"Professor and Department Chair, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-89-2-214-b01","series-title":"Cleft Palate Craniofac J","first-page":"24","article-title":"Cleft lip and palate care in the United Kingdom - The Clinical Standards Advisory Group (CSAG) study. Part 2: Dentofacial outcomes and patient satisfaction","volume":"38","author":"Williams \n              AC,","year":"2001","unstructured":"Williams \n              AC, \n            \n            \n              Bearn \n              D, \n            \n            \n              Mildinhall \n              S, \n            \n            et al. \n          Cleft lip and palate care in the United Kingdom - The Clinical Standards Advisory Group (CSAG) study. Part 2: Dentofacial outcomes and patient satisfaction. Cleft Palate Craniofac J. 2001;38:24\u201329."},{"key":"i0003-3219-89-2-214-b02","series-title":"Angle Orthod","first-page":"31","article-title":"Soft tissue profile changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate","volume":"67","author":"Chen \n              KF,","year":"1997","unstructured":"Chen \n              KF, \n            \n            \n              So \n              LL. \n            \n          \n          Soft tissue profile changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate. 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Angle Orthod. 2012;82:935\u2013941."},{"key":"i0003-3219-89-2-214-b04","series-title":"Cleft Palate Craniofac J","first-page":"585","article-title":"Increase in sagittal depth of the bony nasopharynx following maxillary protraction in patients with unilateral cleft lip and palate","volume":"51","author":"Singla \n              S,","year":"2014","unstructured":"Singla \n              S, \n            \n            \n              Utreja \n              A, \n            \n            \n              Singh \n              SP, \n            \n            \n              Lou \n              W, \n            \n            \n              Suri \n              S. \n            \n          \n          Increase in sagittal depth of the bony nasopharynx following maxillary protraction in patients with unilateral cleft lip and palate. Cleft Palate Craniofac J. 2014;51:585\u2013592."},{"key":"i0003-3219-89-2-214-b05","series-title":"Cleft Palate Craniofac J","first-page":"514","article-title":"Maxillary protraction in patients with cleft lip and palate in mixed dentition: cephalometric evaluation after completion of growth","volume":"51","author":"Susami \n              T,","year":"2014","unstructured":"Susami \n              T, \n            \n            \n              Okayasu \n              M, \n            \n            \n              Inokuchi \n              T, \n            \n            et al. \n          Maxillary protraction in patients with cleft lip and palate in mixed dentition: cephalometric evaluation after completion of growth. Cleft Palate Craniofac J. 2014;51:514\u2013524."},{"key":"i0003-3219-89-2-214-b06","series-title":"Angle Orthod","first-page":"915","article-title":"Long-term efficacy of reverse pull headgear therapy","volume":"76","author":"Wells \n              AP,","year":"2006","unstructured":"Wells \n              AP, \n            \n            \n              Sarver \n              DM, \n            \n            \n              Proffit \n              WR. \n            \n          \n          Long-term efficacy of reverse pull headgear therapy. 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Angle Orthod. 2017;88;157\u2013162."},{"key":"i0003-3219-89-2-214-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"193","article-title":"Prediction of long-term success of orthopedic treatment in skeletal Class III malocclusions","volume":"152","author":"Choi \n              YJ,","year":"2017","unstructured":"Choi \n              YJ, \n            \n            \n              Chang \n              JE, \n            \n            \n              Chung \n              CJ, \n            \n            \n              Tahk \n              JH, \n            \n            \n              Kim \n              KH. \n            \n          \n          Prediction of long-term success of orthopedic treatment in skeletal Class III malocclusions. 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J Orofac Orthop. 2017;78:293\u2013299."},{"key":"i0003-3219-89-2-214-b10","series-title":"Angle Orthod","first-page":"747","article-title":"Cephalometric predictors of long-term stability in the early treatment of Class III malocclusion","volume":"75","author":"Moon \n              YM,","year":"2005","unstructured":"Moon \n              YM, \n            \n            \n              Ahn \n              SJ, \n            \n            \n              Chang \n              YI. \n            \n          \n          Cephalometric predictors of long-term stability in the early treatment of Class III malocclusion. Angle Orthod. 2005;75:747\u2013753."},{"key":"i0003-3219-89-2-214-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"16","article-title":"Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy","volume":"126","author":"Baccetti \n              T,","year":"2004","unstructured":"Baccetti \n              T, \n            \n            \n              Franchi \n              L, \n            \n            \n              McNamara \n              JA\n              Jr. \n            \n          \n          Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop. 2004;126:16\u201322."},{"key":"i0003-3219-89-2-214-b12","series-title":"Eur J Orthod","first-page":"95","article-title":"Long-term follow-up of early treatment with reverse headgear","volume":"25","author":"Hagg \n              U,","year":"2003","unstructured":"Hagg \n              U, \n            \n            \n              Tse \n              A, \n            \n            \n              Bendeus \n              M, \n            \n            \n              Rabie \n              AB. \n            \n          \n          Long-term follow-up of early treatment with reverse headgear. Eur J Orthod. 2003;25:95\u2013102."},{"key":"i0003-3219-89-2-214-b13","series-title":"Angle Orthod","first-page":"617","article-title":"Maxillary protraction effects on anterior crossbites. Repaired unilateral cleft versus noncleft prepubertal boys","volume":"78","author":"Jia \n              H,","year":"2008","unstructured":"Jia \n              H, \n            \n            \n              Li \n              W, \n            \n            \n              Lin \n              J. \n            \n          \n          Maxillary protraction effects on anterior crossbites. Repaired unilateral cleft versus noncleft prepubertal boys. Angle Orthod. 2008;78:617\u2013624."},{"key":"i0003-3219-89-2-214-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"673","article-title":"Effects of maxillary protraction therapy on the pharyngeal airway in patients with repaired unilateral cleft lip and palate: a 3-dimensional computed tomographic study","volume":"149","author":"Fu \n              Z,","year":"2016","unstructured":"Fu \n              Z, \n            \n            \n              Lin \n              Y, \n            \n            \n              Ma \n              L, \n            \n            \n              Li \n              W. \n            \n          \n          Effects of maxillary protraction therapy on the pharyngeal airway in patients with repaired unilateral cleft lip and palate: a 3-dimensional computed tomographic study. 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Cleft Palate J. 1986;23:175\u2013205."},{"key":"i0003-3219-89-2-214-b16","series-title":"Angle Orthod","first-page":"316","article-title":"An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth","volume":"72","author":"Baccetti \n              T,","year":"2002","unstructured":"Baccetti \n              T, \n            \n            \n              Franchi \n              L, \n            \n            \n              McNamara \n              JA. \n            \n          \n          An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. 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Angle Orthod. 2012;82:935\u2013941."},{"key":"i0003-3219-89-2-214-b04","series-title":"Cleft Palate Craniofac J","first-page":"585","article-title":"Increase in sagittal depth of the bony nasopharynx following maxillary protraction in patients with unilateral cleft lip and palate","volume":"51","author":"Singla \n              S,","year":"2014","unstructured":"Singla \n              S, \n            \n            \n              Utreja \n              A, \n            \n            \n              Singh \n              SP, \n            \n            \n              Lou \n              W, \n            \n            \n              Suri \n              S. \n            \n          \n          Increase in sagittal depth of the bony nasopharynx following maxillary protraction in patients with unilateral cleft lip and palate. 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Cleft Palate Craniofac J. 2014;51:514\u2013524."},{"key":"i0003-3219-89-2-214-b06","series-title":"Angle Orthod","first-page":"915","article-title":"Long-term efficacy of reverse pull headgear therapy","volume":"76","author":"Wells \n              AP,","year":"2006","unstructured":"Wells \n              AP, \n            \n            \n              Sarver \n              DM, \n            \n            \n              Proffit \n              WR. \n            \n          \n          Long-term efficacy of reverse pull headgear therapy. 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Am J Orthod Dentofacial Orthop. 2017;152:193\u2013203."},{"key":"i0003-3219-89-2-214-b09","series-title":"J Orofac Orthop","first-page":"293","article-title":"Long-term skeletal and dental effects of facemask versus chincup treatment in Class III patients: a retrospective study","volume":"78","author":"Wendl \n              B,","year":"2017","unstructured":"Wendl \n              B, \n            \n            \n              Stampfl \n              M, \n            \n            \n              Muchitsch \n              AP, \n            \n            et al. \n          Long-term skeletal and dental effects of facemask versus chincup treatment in Class III patients: a retrospective study. J Orofac Orthop. 2017;78:293\u2013299."},{"key":"i0003-3219-89-2-214-b10","series-title":"Angle Orthod","first-page":"747","article-title":"Cephalometric predictors of long-term stability in the early treatment of Class III malocclusion","volume":"75","author":"Moon \n              YM,","year":"2005","unstructured":"Moon \n              YM, \n            \n            \n              Ahn \n              SJ, \n            \n            \n              Chang \n              YI. \n            \n          \n          Cephalometric predictors of long-term stability in the early treatment of Class III malocclusion. Angle Orthod. 2005;75:747\u2013753."},{"key":"i0003-3219-89-2-214-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"16","article-title":"Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy","volume":"126","author":"Baccetti \n              T,","year":"2004","unstructured":"Baccetti \n              T, \n            \n            \n              Franchi \n              L, \n            \n            \n              McNamara \n              JA\n              Jr. \n            \n          \n          Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop. 2004;126:16\u201322."},{"key":"i0003-3219-89-2-214-b12","series-title":"Eur J Orthod","first-page":"95","article-title":"Long-term follow-up of early treatment with reverse headgear","volume":"25","author":"Hagg \n              U,","year":"2003","unstructured":"Hagg \n              U, \n            \n            \n              Tse \n              A, \n            \n            \n              Bendeus \n              M, \n            \n            \n              Rabie \n              AB. \n            \n          \n          Long-term follow-up of early treatment with reverse headgear. Eur J Orthod. 2003;25:95\u2013102."},{"key":"i0003-3219-89-2-214-b13","series-title":"Angle Orthod","first-page":"617","article-title":"Maxillary protraction effects on anterior crossbites. 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