# Dento-Skeletal Class III Treatment with Mixed Anchored Palatal Expander: A Systematic Review
## 3 Results
### Skeletal Effects  
In sagittal dimension, [PERSON] et al., [PERSON] et al. and [PERSON] et al. [4; 15; 56] showed maxillary protraction (SNA 1.87 \(\pm\) 1.06\({}^{\circ}\); Vert.T-A 3.29 \(\pm\) 1.54 mm \(p<\) 0.001), whereas the mandibular base significantly retropositioned (SNB \(-\)2.03\({}^{\circ}\)\(\pm\) 0.85\({}^{\circ}\); Vert.T-B \(-\)3.43 \(\pm\) 4.47 mm, \(p<\) 0.001 and \(p<\) 0.05, respectively), resulting in a better skeletal relationship (ANB 3.95\({}^{\circ}\)\(\pm\) 0.57\({}^{\circ}\), \(p<\) 0.001; Wits 5.15 \(\pm\) 1.51 mm, \(p<\) 0.001). [PERSON] et al. [49] also showed a maxillary advancement (SNA +2.50\({}^{\circ}\); Vert.T-A +3.4 mm), while the mandibular base redirected posteriorly (SNB \(-\)0.92\({}^{\circ}\); Vert.T-B \(-\)0.26 mm). The mandibular plane rotated clockwise, improving the ANB (+ 3.41\({}^{\circ}\)) and the Wits index (+ 4.92 mm). [PERSON] et al. [29] did not consider these parameters but specified only an improvement of Wits appraisal (2.7 \(\pm\) 1.3 mm) and an expansion in the first premolar/first primary molar region and in the first molar region (+ 6.3 \(\pm\) 2.9 mm and +5.0 \(\pm\)1.5 mm, respectively). [PERSON] et al. [51] recorded an increase of 2.4\({}^{\circ}\) and 2.4 mm SNA and A point to Nasion perpendicular, respectively. Moreover, a significant reduction in CoGn (\(-\)2.3 mm) and SNB (\(-\)1.7\({}^{\circ}\)) was recorded. The Wits index increased by 4.5 mm, and the ANB angle improved by 4.1\({}^{\circ}\). [PERSON] et al. [50] recorded an SNA increase of 2\({}^{\circ}\), and the maxilla underwent statistically significant amounts of caudal movement (S-Spa: +3.20; S-Spp: +1.21; N-Spa: +1.84; N-Spp: +2.89), whereas the maxillary inclination had not changed (NL/NSL: \(-\)0.06\({}^{\circ}\)). Furthermore, a mean mandibular post-rotation was assessed (ML/NSL: +1.46). For the vertical measurements, [PERSON] et al. [49] recorded that the facial angle (SN-GoGn) increased by 1.64\({}^{\circ}\) during treatment and the SN-PP angle was reduced by 1.11\({}^{\circ}\). [PERSON] et al. and [PERSON] et al. [4; 15] indicated Y-axis and lower third (ANS-Me) significant increases (1.95 \(\pm\) 1.22\({}^{\circ}\) and 3.19 \(\pm\) 2.2 mm, respectively), indicating a post-rotation of the mandible. The middle facial height (N-ANS) (0.32 \(\pm\) 1.53 mm) showed no significant increase. [PERSON] et al. [51] reported that vertical growth was contained as indicated by a slight increase in the FMA angle (0.5\({}^{\circ}\)) and a little reduction in the Co-Go-Me angle (2.0\({}^{\circ}\)). The other skeletal vertical values showed no significant differences. [PERSON] et al. [50] revealed increases in the vertical parameters ML/NSL (+1.46) and Bjork sum (+1.46). [PERSON] et al. [55] reported that both FM and FM + MS patients showed a significant increase in maxillary forward growth without mandibular forward growth. During the active treatment, SNA (FM + MS group: 2.28 \(\pm\) 1.38; FM group: 1.18 \(\pm\) 1.08; \(p<\) 0.01), SN-ANS (FM + MS group: 2.58 \(\pm\) 1.78; FM group:1.28 \(\pm\) 1.38; \(p<\) 0.05) and ANB (FM + MSgroup: 2.08 \(\pm\) 1.38; FM group: 1.28 \(\pm\) 1.28; \(p\) < 0.05) change was significantly greater in the FM + MS group than in the FM group. [PERSON] et al. [54] found similar maxillary advancement (OLp-A pt., 0.7 mm) and mandible retropositioning (OLp-Pg, 2.2 mm) in both groups. Both the tooth-borne (Wits 2.19 mm, ANB 2.58\({}^{\circ}\)) and the bone-anchored (Wits 2.31 mm, ANB 2.17\({}^{\circ}\)) groups improved their anteroposterior jaw relationship. Other than that, the tooth-borne (OLparallel-A pt. 1.2 mm) protraction facemask group had a substantially larger downward displacement of the maxilla than the bone-anchored protraction facemask group (\(-\)0.4 mm, \(p\) < 0.005). The tooth-borne group had a considerably higher mandibular plane angle (SNL-ML 2.76\({}^{\circ}\)) than the bone-anchored protraction face-mask group (\(-\)0.25\({}^{\circ}\), 0.23\({}^{\circ}\), \(p\) < 0.05). [PERSON] et al.