Effect of Maxillary Expansion and Protraction in Class III Children on Quality of Life, Dentofacial and Upper Airway Characteristics: A Controlled Clinical Trial

ABSTRACT Objective To explore the relationship between early dentofacial orthopaedic treatment, improvement in the width of oropharynx and nasopharynx, and quality of life. Materials and Methods Thirty‐three prepubertal children with skeletal Class III (median age 9 years; 56% females) received treatment with a maxillary expander and facemask. These subjects were matched with two control groups: one comprising an equal number of untreated Class III individuals, and the other consisting of untreated Class I controls. Cephalograms were analysed, and both children and their parents self‐administered the Child Perceptions Questionnaire, Parental‐Caregiver Perceptions Questionnaire and Family Impact Scale. Results Treated Class III cases showed significant increases in the nasopharyngeal and oropharyngeal airway width ( p ≤ 0.033), with greater changes in the nasopharyngeal width compared to untreated Class III cases ( p = 0.040). Compared to untreated Class III and Class I groups, treated Class III cases exhibited reduced mandibular prominence and sagittal skeletal Class, increased overjet, overbite, vertical facial dimension, and greater retroclination and retrusion of mandibular incisors ( p ≤ 0.011). Prior to and following orthodontic treatment, Class III cases reported a lower quality of life across all dimensions compared to Class I controls ( p ≤ 0.032). An increase in maxillary anterior movement and oropharyngeal width correlated with a decrease in functional limitations reported by children ( r = −0.411‐(−0.413)); ( p ≤ 0.022). Conclusion Maxillary expansion and protraction in prepubertal Class III children can enhance upper airways width, and children associate these improvements with a reduction in functional limitations.