R.M.S. bite corrector: A novel appliance for the correction of mandibular prognathism in growing children-Part one: Skeletal and dental changes

Introduction and Aim: Mandibular prognathism is one of the most challenging conditions in clinical dental practice. No appliance has yet been introduced to manage this strenuous condition. Hence, a modified appliance, R.M.S. (removable acrylic splint) bite corrector was fabricated combining the principles of three conventional appliances. The aim was to evaluate the skeletal and dental changes following R.M.S bite corrector in growing children with mandibular prognathism, using lateral cephalograms. Materials and Methods: Twenty children between the age group 9 - 13 years, presenting with class III malocclusion with prognathic mandible were selected. R.M.S bite corrector was fabricated, which consist of reverse twin block with RME (Rapid Maxillary Expansion) incorporated in the upper block. Hooks integrated in the molar region of the upper block, and between the lateral incisors and canines in the lower block. A gradual increasing force was delivered by engaging intraoral intermaxillary elastics. After 10 months, skeletal, dental, and dentoalveolar parameters and linear measurements of jaw bases were compared using pre- and post-operative lateral cephalograms. Results: After 10 months, skeletal changes included a significant retrusion of the mandible and maxillary protraction. Dental changes comprised of an increase in proclination of maxillary and mandibular incisors, which was not significant. A significant increase in the length of the maxillary base, non-significant change in the linear measurements of the mandibular base and ramal length leading to relocation of the mandible in a relatively new position with better esthetics. Conclusion: Desirable skeletal and dental changes were observed following R.M.S. bite correction.