{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T11:15:13Z","timestamp":1772450113696,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: This retrospective comparative cohort study investigated the craniofacial growth effects of the RAMPA (Right Angle Maxillary Protraction Appliance) system. The system aims to protract the maxilla in an anterosuperior direction to address maxillary hypoplasia and skeletal Class III malocclusion, potentially mitigating the posteroinferior displacement often associated with conventional orthopedic approaches. Materials and Methods: Craniofacial measurements were analyzed before (T1) and after (T2) RAMPA treatment in 30 growing patients (17 males, mean age 7.32 years; 13 females, mean age 8.34 years). Coben analysis was utilized to quantitatively evaluate coordinate relationships and proportional changes based on the Frankfurt Horizontal plane. Statistical significance was determined using paired t-tests or Wilcoxon signed-rank tests (two-sided, \u03b1 = 0.05) without adjustment for multiple comparisons due to the exploratory nature of the study. Results: RAMPA treatment was associated with significant increases in facial depth (Ba-N) and anterior facial height (N-Me) in both sexes. Specifically, facial depth increased by an average of 2.65 mm in males (p = 0.001) and 2.18 mm in females (p = 0.007). Female patients showed a significant increase in the maxillary depth ratio (Ptm-A\/Ba-N), while males exhibited a significant decrease in the Gonial Angle (avg. 1.47\u00b0 decrease), suggesting anterior mandibular rotation. Conclusions: RAMPA treatment effectively promoted anterosuperior craniofacial growth and induced favorable mandibular rotation in this cohort. These findings suggest the system has potential clinical value for improving craniofacial balance in skeletal Class III malocclusion. While improved cervical posture is a theoretical benefit of such remodeling, systemic outcomes were not directly measured in this study.<\/jats:p>","DOI":"10.3390\/jcm15051882","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T10:24:34Z","timestamp":1772447074000},"page":"1882","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["RAMPA Therapy: Effects on Craniofacial Growth Assessed by Coben Analysis and Statistical Evaluation"],"prefix":"10.3390","volume":"15","author":[{"given":"Yasushi","family":"Mitani","sequence":"first","affiliation":[{"name":"Codomo Clinic, Tokyo 180-0004, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Okai-Kojima","sequence":"additional","affiliation":[{"name":"Children and Women Dental Clinic, Tokyo 106-0046, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahisa","family":"Shimazaki","sequence":"additional","affiliation":[{"name":"Shimazaki Orthodontic Office, Ibaraki 316-0013, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2523-7509","authenticated-orcid":false,"given":"Mohammad","family":"Moshfeghi","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Sogang University, Seoul 04107, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morio","family":"Tonogi","sequence":"additional","affiliation":[{"name":"Department of Oral & Maxillofacial Surgery, School of Dentistry, Nihon University, Tokyo 101-8310, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3133-4300","authenticated-orcid":false,"given":"Shouhei","family":"Ogisawa","sequence":"additional","affiliation":[{"name":"Department of Oral & Maxillofacial Surgery, School of Dentistry, Nihon University, Tokyo 101-8310, Japan"},{"name":"Yokohama Clinic, Department of Advanced Oral and Maxillofacial Surgery, Kanagawa Dental University, Yokohama 221-0835, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bumkyoo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Sogang University, Seoul 04107, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8705-5757","authenticated-orcid":false,"given":"Mitsuru","family":"Motoyoshi","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Nihon University School of Dentistry, Tokyo 101-8310, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,1]]},"reference":[{"key":"ref_1","unstructured":"Proffit, W.R., Fields, H.W., Larson, B., and Sarver, D.M. 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