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Maxillary protraction using a hybrid hyrax-facemask combination

Manuel Nienkemper*, Benedict Wilmes, Alexander Pauls and Dieter Drescher

Author Affiliations

University of Düsseldorf, Department of orthodontics, Moorenstr. 5, 40225 Düsseldorf, Germany

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Progress in Orthodontics 2013, 14:5  doi:10.1186/2196-1042-14-5

Published: 20 May 2013



The aim of this in study was the evaluation of treatment outcomes after using a hybrid hyrax-facemask combination in growing class III patients.


Treatment of 16 children (mean age 9.5 ± 1.3 years) was investigated clinically and by means of pre- and post-treatment cephalograms. Changes in sagittal and vertical, and dental and skeletal values were evaluated and tested for statistically significant differences.


All mini-implants remained stable during treatment. Mean treatment duration was 5.8 ± 1.7 months. There was a significant improvement in skeletal sagittal values: SNA, +2.0°; SNB, -1.2°; ANB, +3.2°; WITS appraisal, +4.1 mm and overjet, +2.7 mm. No significant changes were found concerning vertical skeletal relationships and upper incisor inclination. In relation to A point, the upper first molars moved mesially about 0.4 mm (P = 0.134).


The hybrid hyrax-facemask combination seems to be effective for orthopaedic treatment in growing class III patients. Unwanted maxillary dental movements can be avoided due to stable skeletal anchorage.