Indications:

• Skeletal Class III malocclusion in growing patients.

• Maxillary retrusion (hypoplasia) with anterior crossbite.

• Early to mid–mixed dentition (before completion of growth spurt).

• Alternative to facemask protraction therapy.

Contraindications:

• Non-growing patients (after pubertal growth spurt).

• Severe skeletal Class III requiring orthognathic surgery.

• Poor compliance (removable component requires wear).

• Cases with severe mandibular prognathism.

Corrects:

• Stimulates forward and downward growth of the maxilla.

• Restrains excessive mandibular forward displacement.

• Corrects anterior crossbite and negative overjet.

• Improves midface projection.

Design:

• Intraoral component: Maxillary molar bands with soldered tubes supporting a facebow–like framework.

• Outer facebow replaced by a short traction bow with hooks extending anteriorly.

• Removable component: Chin cup or intraoral traction unit with elastics connecting to anterior bow.

• Forces directed anteriorly and slightly downward to protract maxilla.

Philosophy:

• Works on orthopedic protraction of the maxilla using intraoral force application (instead of extraoral facemask).

• Applies light continuous forces (≈350–450 g per side) through elastics from chin/cervical pad to traction bow.

• Encourages forward displacement of the maxilla and counteracts mandibular prognathism.

Modifications:

• Can be combined with a rapid maxillary expansion appliance before traction (to loosen circummaxillary sutures).

• Variants with acrylic bonded splints instead of bands.

• Elastic vectors can be adjusted (more vertical for open bite control or more horizontal for sagittal correction).

• Hybrid TTBA with skeletal anchorage (miniplates/miniscrews) in severe cases

Advantages:

·         Effective for early Class III correction → stimulates maxillary protraction while redirecting mandibular growth.

·         Combines intraoral and extraoral mechanics for controlled orthopedic forces.

·         Encourages forward growth of the maxilla while restraining excessive mandibular prognathism.

·         Can be used in mixed dentition → ideal for interceptive treatment in growing children.

·         Facilitates positive overjet and overbite correction without excessive dental compensation.

·         Customized force application → allows adjustment of protraction vectors.

·         Alternative to facemask therapy → better esthetics and compliance since less bulky.

MaxDent fabrication advantage → precise fit, durable soldering, and patient-friendly design for comfort