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February 2, 2026BMJ Open0 citationsOpen Access

Efficacy of anterior intrusion-based vertical control versus conventional sagittal retraction in adolescents with hyperdivergent mandibular retrognathia: study protocol for a randomised controlled trial

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SSShuangshuang ShiWZWei ZhangWZWeihua Zhang

Key Points

  • This trial aims to assess the effectiveness of a micro-implant-assisted method for correcting mandibular retrognathia compared to conventional techniques.
  • Randomised controlled trial design with a two-arm approach
  • Total of 90 adolescents recruited from three hospitals in Shanghai
  • Participants randomly allocated to either a micro-implant group or a control group receiving traditional treatment
  • Primary outcome measured is the A point-nasion-B point angle, with secondary outcomes including changes in occlusal plane and facial heights
  • Measurements taken at baseline, end of treatment, and 12 months post-treatment
  • The micro-implant group is anticipated to show more improvement in facial profile compared to the control group
  • Expected positive changes in the occlusal plane and mandibular positioning
  • Improvement in pharyngeal space under micro-implant protocol

Abstract

Introduction Hyperdivergent skeletal class II malocclusion in adolescents is characterised by mandibular retrognathia with excessive vertical growth and clockwise mandibular rotation, which can worsen facial profile and airway-related morphology. Although mandibular advancement approaches are commonly used, they may increase the vertical dimension and are suboptimal for patients with long-face patterns. This randomised controlled trial aims to evaluate a micro-implant-assisted protrusion correction technique designed to flatten the occlusal plane and promote counterclockwise mandibular rotation, thereby improving facial profile and pharyngeal space. Methods and analysis This trial is registered at the Chinese Clinical Trial Registry (ChiCTR; ChiCTR2100054105). This is a two-arm, multicentre, randomised, parallel-controlled trial. Ninety adolescents will be recruited from Shanghai Stomatological Hospital, Zhongshan Hospital (Fudan University), and Xinhua Hospital (Shanghai Jiao Tong University School of Medicine), and will be randomly allocated (1:1) to the test or control group. The control group will receive conventional anterior teeth retraction, whereas the test group will receive a micro-implant-assisted vertical control protocol with occlusal plane flattening. The primary outcome is the change in the A point–nasion–B point angle. Secondary outcomes include changes in the occlusal plane, incisor and molar heights, and facial height. Measurements will be assessed at baseline, at the end of treatment and at 12 months after treatment completion. Ethics and dissemination This study was approved by the Ethics Committee of the Shanghai Stomatological Hospital (approval no. (2022)006). The results of this study will be made available in peer-reviewed journals. Trial registration number ChiCTR2100054105.

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Cite This Study

Shi et al. (2026) studied this question.

synapsesocial.com/papers/6980fe48c1c9540dea81026bhttps://doi.org/10.1136/bmjopen-2024-091880
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