Skeletal changes
In the treated group, the maxilla and the midface showed significant advancements which were 4 to 5 times greater than the control group. These results are consistent with the results of previous studies [A significant control over the growth of the mandible (B-VR change) was observed in the treated group (− 0.26 mm) compared with the control group (1.37 mm), suggesting that this treatment protocol restricted the growth of the mandible, as reported in previous studies [In the treated group, the maxillomandibular relationship was improved by the sagittal movement of the maxilla and minimal backward rotation of the mandible. In addition, the ANB angle and Wits were improved significantly. These results are in agreement with those of other studies [