Review Article

Evaluation the effect of maxillary protraction on the airway dimensions: A review


Aim and Objective: The aim of this study was to evaluate the effect of maxillary protraction on airway dimensions in growing patients.Materials and Methods: The research was conducted using literature reviews. Articles included in databases such as PubMed, Embase, Google Scholar and Cochrane were reviewed via inputting keywords such as maxillary protraction, maxilla retrusion, retrognathic, class III malocclusion, face mask, reverse head gear, Delaire, protraction head gear, reverse occlusion, anterior crossbite, growing patient, bone anchorage, dental anchorage. The search period for articles ranged from January 2005 to April 2021. Results: 7 articles with inclusion criteria were included in the study; the results of the studies showed the effectiveness of maxillary protraction on increasing the dimensions of the airway. Studies have shown a significant increase in the size of the upper airway, especially the nasopharynx, following maxillary protraction with tooth-borne and bone-borne appliances. Conclusion: Maxillary protraction can increase the size of the upper airway in growing patients. However, further studies are needed to elucidate the effects on changes in the pharyngeal airway, respiratory indicators (such as the apnea-hypopnea index), and its long-term effects.
1.Mirhashemi AH, Arab S, Bahrami R. Orthodontics as a therapeutic tool for managing sleep apnea: A review. Journal of Craniomaxillofacial Research.2020 Oct 3:50-61.
2.Ming Y, Hu Y, Li Y, et al. Effects of maxillary protraction appliances on airway dimensions in growing class III maxillary retrognathic patients: a systematic review and meta-analysis. Int J PediatrOtorhinolaryngol. 2018;105:138–45.
3.Helal N, Ford M, Basri O, Schuster L, Martin B, Losee J. Relationship of velopharyngeal insufficiency with face mask therapy in patients with cleft lip and palate. The Cleft Palate-Craniofacial Journal. 2020 Jan;57(1):118-22.
4.Kambara T. Dentofacial changes produced by extraoral forward force in the Macacairus. American Journal of Orthodontics. 1977 Mar 1;71(3):249-77.
5.Gallagher RW, Miranda F, Buschang P. Maxillary protraction: treatment and posttreatment effects. American Journal of Orthodontics and Dentofacial Orthopedics. 1998 Jun 1;113(6):612-9.
6.Tanne K, Hiraga J, Sakuda M. Effects of directions of maxillary protraction forces on biomechanical changes in craniofacial complex. The European Journal of Orthodontics. 1989 Nov 1;11(4):382-91.
7.Hata S, Itoh T, Nakagawa M, Kamogashira K, Ichikawa K, Matsumoto M, Chaconas SJ. Biomechanical effects of maxillary protraction on the craniofacial complex.American Journal of Orthodontics and Dentofacial Orthopedics. 1987 Apr 1;91(4):305-11.
8.Kim JE, Yim S, Choi JY, Kim S, Kim SJ, Baek SH. Effects of the long-term use of maxillary protraction facemasks with skeletal anchorage on pharyngeal airway dimensions in growing patients with cleft lip and palate. Korean Journal of Orthodontics. 2020 Jul 25;50(4):238.
9.Quo S, Lo LF, Guilleminault C. Maxillary protraction to treat pediatric obstructive sleep apnea and maxillary retrusion: a preliminary report. Sleep medicine. 2019 Aug 1;60:60-8.
10.Danaei SM, Ajami S, Etemadi H, Azadeh N. Assessment of the effect of maxillary protraction appliance on pharyngeal airway dimensions in relation to changes in tongue posture. Dental research journal. 2018 May;15(3):208.
11.BALOŞ TUNCER B, Ulusoy Ç, Tuncer C, Türköz Ç, Kale Varlik S. Effects of reverse headgear on pharyngeal airway in patients with different vertical craniofacial features. Brazilian oral research. 2015;29(1):1-8.
12.Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.PLoS Med. 2009;6(7):e1000097. DOI: 10.1371/journal.pmed.1000097.
13.15. National Institute for Health and Care Excellence (Great Britain).Methods for the development of NICE public health guidance.National Institute for Health and Care Excellence; 2012.
14.Lee JW, Park KH, Kim SH, Park YG, Kim SJ. Correlation between skeletal changes by maxillary protraction and upper airway dimensions. The Angle Orthodontist. 2011 May;81(3):426-32.
15. Kaygısız E, Tuncer BB, Yüksel S, Tuncer C, Yıldız C. Effects of maxillary protraction and fixed appliance therapy on the pharyngeal airway. The Angle Orthodontist. 2009 Jul;79(4):660-7.
16.Akin M, Ucar FI, Chousein C, Sari Z. Effects of chincup or facemask therapies on the orofacial airway and hyoid position in Class III subjects.
17.Oktay H, Ulukaya E. Maxillary protraction appliance effect on the size of the upper airway passage. The Angle Orthodontist. 2008 Mar;78(2):209-14.
18.Baccetti T, Franchi L, Mucedero M, Cozza P. Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in Class III subjects. The European Journal of Orthodontics. 2010 Jun 1;32(3):346-50.
19.Sayınsu K, Isik F, Arun T. Sagittal airway dimensions following maxillary protraction: a pilot study. The European Journal of Orthodontics. 2006 Apr 1;28(2):184-9.
20.Seo WG, Han SJ. Comparison of the effects on the pharyngeal airway space of maxillary protraction appliances according to the methods of anchorage.Maxillofacial plastic and reconstructive surgery. 2017 Dec;39(1):1-9.
IssueVol 8, No 4 (Autumn 2021) QRcode
SectionReview Article(s)
Maxillary protraction Maxilla retrusion Retrognathic Class III malocclusion Face mask Reverse head gear Delaire Protraction head gear Reverse occlusion Anterior crossbite Growing Patient Bone anchorage Dental anchorage

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Mirhashemi SA, Ghadirian H, Bahrami R. Evaluation the effect of maxillary protraction on the airway dimensions: A review. J Craniomaxillofac Res. 2022;8(4):164-171.