Reverse Forsus vs. facemask/rapid palatal expansion appliances in growing subjects with mild class III malocclusions

To investigate the skeletal, dental, and soft tissue effects of reverse Forsus (RF; 3M Unitek, Monrovia, CA, USA) and facemask/rapid palatal expansion (FM/RPE) appliances in growing subjects with class III malocclusions. The data of this prospective randomized controlled trial (RCT) were derived from pre- and posttreatment/observation lateral cephalograms of 45 subjects with mild class III malocclusions: group 1 (8 girls, 7 boys; mean age 10.54 years) received a FM/RPE appliance; group 2 (6 girls, 9 boys; mean age 10.49 years) received the RF appliance; and an untreated control group (7 girls, 8 boys; mean age 10.66 years) was matched to the treatment groups with regard to sagittal skeletal and dental classifications. Angular and linear measurements were evaluated using lateral cephalograms. Statistical analyses were performed by one-way analysis of variance, Kolmogorov–Smirnov test, Kruskal–Wallis, paired-samples t‑test, and Wilcoxon test, whereby p < 0.05 was accepted to be statistically significant. The intermaxillary (ANB), interdental (overjet), and sagittal lip relations in the FM/RPE and RF groups showed significant improvements compared to the control group (p < 0.05). Although the anterior and inferior traction of the maxilla was greater in the FM/RPE group compared to the RF group (p < 0.05), both treatment groups showed similar clockwise rotation of the mandible compared to the control group. While significantly more proclination of maxillary incisors occurred in the RF group compared to the FM/RPE and control groups (p < 0.05), both treatments led to significantly retroclined mandibular incisors compared to the control group (p < 0.001). Both therapies led to intermaxillary and interdental improvements. The RF appliance had a limited effect on the maxilla and it mostly had dentoalveolar effects when compared to FM/RPE therapy.