# RAMPA Therapy: Effects on Craniofacial Growth Assessed by Coben Analysis and Statistical Evaluation

## TL;DR

A study found that the RAMPA appliance promotes facial growth and improves jaw alignment in children with skeletal Class III malocclusion.

## Contribution

The study demonstrates the RAMPA system's effectiveness in inducing anterosuperior craniofacial growth and favorable mandibular rotation.

## Key findings

- RAMPA treatment significantly increased facial depth and anterior facial height in both male and female patients.
- Female patients showed increased maxillary depth ratio, while males exhibited decreased Gonial Angle, indicating mandibular rotation.
- The RAMPA system appears to promote favorable craniofacial remodeling in growing patients with skeletal Class III malocclusion.

## Abstract

Objective: This retrospective comparative cohort study investigated the craniofacial growth effects of the RAMPA (Right Angle Maxillary Protraction Appliance) system. The system aims to protract the maxilla in an anterosuperior direction to address maxillary hypoplasia and skeletal Class III malocclusion, potentially mitigating the posteroinferior displacement often associated with conventional orthopedic approaches. Materials and Methods: Craniofacial measurements were analyzed before (T1) and after (T2) RAMPA treatment in 30 growing patients (17 males, mean age 7.32 years; 13 females, mean age 8.34 years). Coben analysis was utilized to quantitatively evaluate coordinate relationships and proportional changes based on the Frankfurt Horizontal plane. Statistical significance was determined using paired t-tests or Wilcoxon signed-rank tests (two-sided, α = 0.05) without adjustment for multiple comparisons due to the exploratory nature of the study. Results: RAMPA treatment was associated with significant increases in facial depth (Ba-N) and anterior facial height (N-Me) in both sexes. Specifically, facial depth increased by an average of 2.65 mm in males (p = 0.001) and 2.18 mm in females (p = 0.007). Female patients showed a significant increase in the maxillary depth ratio (Ptm-A/Ba-N), while males exhibited a significant decrease in the Gonial Angle (avg. 1.47° decrease), suggesting anterior mandibular rotation. Conclusions: RAMPA treatment effectively promoted anterosuperior craniofacial growth and induced favorable mandibular rotation in this cohort. These findings suggest the system has potential clinical value for improving craniofacial balance in skeletal Class III malocclusion. While improved cervical posture is a theoretical benefit of such remodeling, systemic outcomes were not directly measured in this study.