Children with reverse bite and large lower jaws have what is termed a class III skeletal pattern. In some cases, the problem is that the upper jaw is set too far back and the treatment is to bring it forwards to correct the reverse bite.
Braces alone cannot correct this gap. In the UK patients do not usually receive corrective treatment until their general and facial growth is complete at 17-18 years of age. At this point, they may be offered jaw surgery to correct the jaw position.
Between the ages 11- 14, patients are often distressed, teased or bullied about their jaw at a time when peer opinion is particularly important to them. Bone Anchored Maxillary Protraction (BAMP) has been used in Europe for 11- 14 year old children to correct their class III jaw relationship without having to wait until they have finished growing.
BAMP consists of small metal plates that are inserted from inside the mouth into the front part of the cheekbone bone next to the upper molars on each side. Further miniplates are positioned into the bone down in the lower canine region near the front of the lower jaw. Elastics are then attached from the upper to the lower plates, via hooks, to bring the upper jaw and teeth forwards and correct the class III skeletal pattern. The mini-plates are placed and later removed as a day-case general anaesthetic procedure and the patient wears the elastics for around 6-8 months.
The aim of the BAMP trial was to compare the effectiveness of BAMP compared with no treatment. We will then be able to evaluate whether BAMP in the age group of 11 to 14 years old reduces the need for surgery in older teenage years.