Re: Rapid maxillary expansion compared to surgery for assistance in maxillary face mask protraction. By Nazan Küçükkeleş, Şirin Nevzatoğlu, and Tamer Koldaş. Angle Orthod. 2011:81;44–51

To: Editor, The Angle Orthodontist

This study was a very good effort by the authors. But there are certain issues to be clarified. In the present study, the mean age of the RME group was 12 years 9 months of which 8 were girls. Most of the authors including the authors of the present study, recommend the face mask therapy to be completed by 10 years of age. A META analysis by Kim et al.1 indicated that face mask is less effective in patients who are older than 10 years of age. That indicates that growth completion could have been one of the reasons that reduced effectiveness of facemask therapy in RME group. In addition, some authors do not concur on the usefulness of RME along with facemask therapy. A Randomized controlled trial by Gregory Vaughan et al.2 showed no difference between expansion and no expansion groups in facemask therapy. They concluded that early facemask therapy with or without expansion is effective to correct skeletal Class III.

In the current study, while one group (RME) underwent a procedure intended to separate the two halves of the maxilla and thereby aid in their protraction, the other group underwent a definite surgical procedure like Le Fort I osteotomy (albeit incomplete) that eased out maxilla from the rest of the bones that would definitely aid in protraction therapy. Further, the RME group was somewhat older than the recommended age for the procedure. The results of the study were therefore very much predictable.

However, we sincerely congratulate the authors for a fine effort, especially for the results of the surgical group which were very impressive.