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Background  The use of face mask for early treatment of class III malocclusion has proven to be successful, but its compliance and related dental side effects have always been a problem. To overcome this, a new approach has been suggested. The purpose of the present study was to compare the effectiveness of reverse twin block with lip pads and fixed rapid maxillary expansion (RTBLP-RME) appliance and face mask with RME (FM-RME) appliance for early treatment of class III malocclusion.    Methods  The sample consisted of 39 patients with class III malocclusion in the age group of 6–12 years (mean 10.17). They were divided into 3 groups of 13 each: reverse twin block with lip pads-RME (RTBLP-RME), face mask with RME (FM-RME), and control group. Treatment time was 9 months. Lateral cephalograms were taken at the start of treatment (T1) and after 9 months (T2) (both groups).    Results  Both appliances were effective in correction of class III malocclusion with significant ( p  < 0.01) changes in all the cephalometric variables except cranial base angulations as compared to the control group. Intergroup comparison showed nonsignificant but greater sagittal changes with RTBLP-RME as compared to the FM-RME group. For all vertical measurements, the RTBLP-RME group showed nonsignificant increase compared to the FM-RME group. Maxillary incisor proclination was less in the RTBLP-RME group than in the FM-RME group, while mandibular incisor proclination was more in the RTBLP-RME group. Condylar inclination was significantly ( p  < 0.01) different for both treatment groups. With the RTBLP-RME group, posterior inclination of the condyle was seen while the FM-RME group showed more forward positioning as compared to the control group.    Conclusion  Both groups were effective in correcting the malocclusion, but RTBLP-RME appliance had nonsignificant but greater impact on maxillary advancement and more hold on the posterior positioning of the mandible with minimal dental compensation as compared to FM-RME appliance.

Effectiveness of reverse twin block with lip pads-RME and face mask with RME in the early treatment of class III malocclusion