Dentoskeletal effects of early class III treatment protocol based on timing of intervention in children

Abstract Background To detect the optimal timing of intervention based on different cervical vertebral maturation stage (CS1-2 vs. CS3-4) for the treatment of Class III malocclusion with early Class III protocol. Methods A total sample of 43 patients (23 females, 20 males) ranging between 7 and 13 years of age with dentoskeletal Class III malocclusion treated with the modified SEC III (Splints, Elastic and Chincup) protocol divided into two groups based on the cervical vertebral maturation stages (CS1-2 and CS3-4) was included in this retrospective observational longitudinal study. Patient compliance was assessed using a 2-point Likert scale. Statistical comparisons between the two groups were performed with independent sample t tests. Results No statistically significant differences for any of the cephalometric variables describing the baseline dentoskeletal features were found between the two groups except for the mandibular unit length that was significantly greater in the pubertal group (P = 0.005). The modified SEC III protocol produced favorable sagittal outcomes in both groups, whereas no statistically significant T1-T2 changes were found between the CS1-2 and CS3-4 groups for any of the angular and linear measurements. No significant differences were found in the prevalence rates of the degree of collaboration between the two groups (P = 1.000). Conclusions No significant differences between prepubertal and pubertal patients were found in the sagittal and vertical dentoskeletal changes with the modified SEC III protocol. Thus, this early Class III treatment produced similar favorable effects in growing subjects regardless of the cervical vertebral maturation stages from CS1 to CS4.

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Sexual dimorphism in the long-term stability (10 years) of skeletal Class III treatment

Progress in Orthodontics ◽

10.1186/s40510-021-00360-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Natalia Tejedor ◽

Conchita Martín ◽

José Antonio Alarcón ◽

María Dolores Oteo-Calatayud ◽

Juan Carlos Palma-Fernández

Keyword(s):

Sexual Dimorphism ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Term Stability ◽

Long Term Stability ◽

Fixed Appliances ◽

Males And Females ◽

Class Iii Treatment

Abstract Background Class III malocclusion is associated with high sexual dimorphism, especially in individuals older than 13 years of age, with significant differences in growth between males and females during the pubertal and postpubertal stages, and in adulthood. The aim of this research was to examine differences between males and females in long-term stability (10 years) of treatment for skeletal Class III malocclusion. Methods Thirty patients (15 males and 15 females) with skeletal Class III malocclusion, who had been treated with rapid maxillary expansion (RME) combined with face mask protraction followed by fixed appliances, were selected sequentially. Thirty patients (15 males and 15 females) with skeletal Class I and mesofacial patterns treated only with fixed appliances for dental problems served as the control group. Differences between groups and sexes were evaluated using lateral cephalograms taken at the start of treatment (T0), immediately after the end of treatment (T1), and after 10 years (T2). The long-term treatment success rate was calculated. Results Ten years after Class III treatment, overjet and overbite relapse occurred similarly in females (− 0.68 ± 0.7 mm; − 0.38 ± 0.75 mm, respectively) and males (− 1.09 ± 1.47 mm; − 0.64 ± 0.9 mm, respectively); the ANB angle and Wits appraisal became significantly more negative in males (− 1.37 ± 1.06°; − 2.7 ± 2.53 mm) than in females (− 0.18 ± 1.26°; − 0.46 ± 1.94 mm). The success rate was 73.3% in males and 80% in females. Conclusions Significant differences in the long-term stability of Class III treatment outcomes have been found between males and females, with a larger skeletal Class III relapse and lower long-term success rates in males.

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Combined Orthodontic-surgical Treatment for Skeletal Class III Malocclusion with Multiple Impacted Permanent and Supernumerary Teeth: Case Report

The Open Dentistry Journal ◽

10.2174/1874210601408010043 ◽

2014 ◽

Vol 8 (1) ◽

pp. 43-48

Author(s):

Dai Juan and Feng Xue

Keyword(s):

Surgical Treatment ◽

Primary Teeth ◽

Treatment Protocol ◽

Deciduous Teeth ◽

Class Iii ◽

Class Iii Malocclusion ◽

Supernumerary Teeth ◽

Sagittal Split Ramus Osteotomy ◽

Impacted Teeth ◽

Skeletal Class

In this report we describe a combined orthodontic and surgical treatment for a 14-year-old boy with severe skeletal class III deformity and dental problem. His upper posterior primary teeth in the left side were over-retained and 6 maxillary teeth (bilateral central incisors and canines, left first and second premolars) were impacted, together with 5 supernumerary teeth in both arches. The treatment protocol involved extraction of all the supernumerary and deciduous teeth, surgical exposure and orthodontic traction of the impacted teeth, a bimaxillary orthognathic approach including Lefort I osteotomy. Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty was performed to correct skeletal problem. After treatment, all of the impacted teeth were brought to proper alignment in the maxillary arch. A satisfied profile and good posterior occlusion was achieved. Treatment mechanics and consideration during different stages are discussed.

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Impact of Orthodontic Decompensation on Bone Insertion

Case Reports in Dentistry ◽

10.1155/2014/341752 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10

Author(s):

Fabio Pinto Guedes ◽

Leopoldino Capelozza Filho ◽

Daniela Gamba Garib ◽

Hugo Nary Filho ◽

Evandro José Borgo ◽

...

Keyword(s):

Tooth Movement ◽

Treatment Protocol ◽

Orthodontic Tooth Movement ◽

Class Iii ◽

Class Iii Malocclusion ◽

Accurate Analysis ◽

Before And After ◽

Facial Pattern ◽

The Relationship ◽

Mandibular Incisors

There has always been concern in determining the relationship between orthodontic tooth movement and the consequent biological costs to the periodontium and tooth root. The possibility of evaluating the tooth and bone morphology by CBCT allows more accurate analysis of qualitative and quantitative aspects of these processes. This paper presents a case report of a 20-year-old male patient with Class III malocclusion and hyperdivergent facial pattern, who was surgically treated. A significant amount of labial movement of mandibular incisors was performed during orthodontic treatment before surgery. CBCT was used for evaluation of buccal and lingual bone plates before and after tooth decompensation. The changes in the bone insertion level of maxillary and mandibular incisors in the present case encourage a reflection on the treatment protocol in individuals with dentoskeletal discrepancies.

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The Removable Mandibular Retractor vs the Boneanchored Intermaxillary Traction in the Correction of Skeletal Class III Malocclusion in Children: A Randomized Controlled Trial

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1856 ◽

2016 ◽

Vol 17 (5) ◽

pp. 361-371 ◽

Cited By ~ 2

Author(s):

Mohammad Y Hajeer ◽

Abdulmalek MR Majanni

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Primary Outcome Measure ◽

Treatment Modalities ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Randomized Controlled ◽

Soft Tissue Changes ◽

Class Iii Treatment

ABSTRACT Background No randomized controlled trial has tried to compare early class III treatment outcomes between the removable mandibular retractor (RMR) and the bone-anchored intermaxillary traction (BAIMT). The objective of this study was to evaluate skeletal, dental, and soft-tissue changes following early class III treatment with these two treatment modalities. Materials and methods A parallel group randomized controlled trial was conducted on patients with class III malocclusion, treated at the University of Al-Baath Dental School in Hamah, Syria. Ninetythree children with skeletal class III malocclusion were evaluated and 41 children fulfilled the inclusion criteria. Randomization was performed using computer-generated tables; allocation was concealed using sequentially numbered opaque and sealed envelopes. Thirty-eight participants were analyzed (mean age 11.46 ± 1.28 years). They were randomly distributed into two groups receiving either the RMR or the BAIMT technique with 19 children in each (1:1 allocation ratio). The primary outcome measure was the horizontal movement of points A, B, and Pogonion. Results Point A showed greater anterior movement in the BAIMT group (x̄ = 1.69 mm) than in the RMR group (x̄ = 1.05 mm; p < 0.001). Points B and Pog showed posterior movement in the BAIMT group (x̄ = −3.01 and −2.51 mm respectively) and anterior movements in the RMR group (x̄ = 0.22 and 0.78 mm respectively). Conclusion The BAIMT appeared to be more effective than the RMR in the correction of mild to moderate class III malocclusion in growing patients. Clinical significance Bone-anchored intermaxillary elastics appears to be a promising solution for class III growing patients with mild to moderate degrees of skeletal discrepancy. How to cite this article Majanni AMR, Hajeer MY. The Removable Mandibular Retractor vs the Bone-anchored Intermaxillary Traction in the Correction of Skeletal Class III Malocclusion in Children: A Randomized Controlled Trial. J Contemp Dent Pract 2016;17(5):361-371.

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Conservative compensatory Angle Class III malocclusion treatment

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512012000600025 ◽

2012 ◽

Vol 17 (6) ◽

pp. 137-145 ◽

Cited By ~ 1

Author(s):

Marcio Costa Sobral ◽

Fernando Antônio de Lima Habib ◽

Liz Matzenbacher

Keyword(s):

Orthognathic Surgery ◽

Tooth Movement ◽

Class Iii ◽

Class Iii Malocclusion ◽

Third Place ◽

Facial Esthetics ◽

Angle Class Iii Malocclusion ◽

Dentofacial Orthopedics ◽

Class Iii Treatment ◽

Angle Class Iii

INTRODUCTION: Angle's Class III malocclusion is a dental discrepancy in a sagittal view that may appear or not with an important skeletal discrepancy. Facial esthetics may be affected by this skeletal discrepancy and it is one of the most common complaints of patients who seek orthodontic treatment. Class III treatment, in adults, may be done by compensatory tooth movement, in simple cases, or through an association between orthodontics and orthognathic surgery, in more severe cases. OBJECTIVE: This article describes a non-extraction compensatory Class III treatment case, applying the Tweed-Merrifield mechanical principles with headgear (J-Hook) in the mandibular arch. This case was presented at the V Brazilian Association of Orthodontics and Dentofacial Orthopedics (ABOR) Meeting, it was evaluated by members of Brazilian Board of Orthodontics and obtained third place in the general classification.

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Treatment Classification of Class III Malocclusion

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.33.2.431877341u182416 ◽

2008 ◽

Vol 33 (2) ◽

pp. 175-186 ◽

Cited By ~ 1

Author(s):

Robert Kanas ◽

Leonard Carapezza ◽

Scott Kanas

Keyword(s):

Classification Systems ◽

Growth Stages ◽

Class Iii ◽

Class Iii Malocclusion ◽

Treatment Protocols ◽

Respective Treatment ◽

New Treatment ◽

Class Iii Treatment ◽

Methods Of Treatment

Purpose: The purpose of this study was to identify Class III malocclusions within a pediatric practice that lend themselves to a more favorable treatment outcome at an earlier age (before 10 years) rather than initiating treatment at later adolescent growth stages and also to identify the degree of difficulty of the treatment of the Class III malocclusion. Methods: Review of the current dental literature pertaining to the different clinical types of Class III malocclusions and their respective treatment protocols was performed. Various classification systems were studied and compared. A new treatment classification system of Class III malocclusions utilizing three dentoalveolar and three skeletal components combined with cephalometric information derived from commonly used cephalometric analyses was developed. Results: Class III treatment types were conclusively identified: 1.) Early orthodontics only, 2.) Early combined orthodontics and orthopedics, 3.) Combined orthodontics and orthognathic surgery. Conclusions: The conclusion supports Edward H. Angle's finding: "In studying a case of malocclusion, give no thought to the methods of treatment or appliances until the case shall have been classified and all peculiarities and variations from the normal type, occlusion and facial lines have been thoroughly comprehended. Then the requirements and proper plan of treatment becomes apparent."

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Early Treatment Protocol for Skeletal Class III Malocclusion

Brazilian Dental Journal ◽

10.1590/0103-6440201301588 ◽

2013 ◽

Vol 24 (2) ◽

pp. 167-173 ◽

Cited By ~ 4

Author(s):

Paula Vanessa Pedron Oltramari-Navarro ◽

Renato Rodrigues de Almeida ◽

Ana Cláudia de Castro Ferreira Conti ◽

Ricardo de Lima Navarro ◽

Marcio Rodrigues de Almeida ◽

...

Keyword(s):

Early Intervention ◽

Treatment Planning ◽

Treatment Protocol ◽

Growth Control ◽

Growth Potential ◽

Etiologic Factor ◽

Class Iii ◽

Class Iii Malocclusion ◽

Maxillary Expansion ◽

Skeletal Class

Skeletal Class III malocclusion, with its unpredictable and unfavorable nature, has been characterized by a growth pattern with doubtful prognosis regarding orthodontic mechanics, even when performed early. For a long time, Class III malocclusion was regarded as a synonym of mandibular prognathism, regardless of the affected skeletal structures. Mandibular growth, essentially determined by genetic factors, could barely be controlled by early orthodontic interventions. Therefore, the treatment choice was to wait for the patient to grow, and then make an orthodontic intervention associated with an orthognathic surgery. Maxillary involvement in the etiology of Class III malocclusion was conclusive to change orthodontic therapeutics. Maxillary intramembranous growth has a better response to orthopedic treatment, based on growth control and redirection, thus contributing for early intervention success. In several cases, excellent results have been achieved with rapid maxillary expansion and protraction. The aim of this study was to describe and discuss the treatment of a patient with Class III malocclusion, whose treatment planning comprised two phases: interceptive (mechanical orthopedic appliances) and comprehensive (fixed orthodontic appliance). The results of this case showed that Class III malocclusion should be intercepted as early as possible to permit growth redirection, mainly when the maxilla is the primary etiologic factor or dental and/or functional factors are involved. Diagnosis, treatment planning and prognosis depend on patient age, growth potential and severity of malocclusion. Early intervention, adequate indication of appliances, and patient compliance are key factors for good outcomes.

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Two-Step Extraction of the Lower First Molar for Class III Treatment in Adult Patient

Case Reports in Dentistry ◽

10.1155/2016/1580313 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8

Author(s):

Kélei Cristina de Mathias Almeida ◽

Ricardo Fabris Paulin ◽

Taísa Barnabé Raveli ◽

Dirceu Barnabé Raveli ◽

Ary Santos-Pinto

Keyword(s):

Case Report ◽

Growth Pattern ◽

Class Iii ◽

Class Iii Malocclusion ◽

Initial Alignment ◽

Posterior Crossbite ◽

Fixed Appliances ◽

Dentoalveolar Compensation ◽

Leveling And Alignment ◽

Class Iii Treatment

The aim of this article is to describe a case report of Class III malocclusion treatment with lower first molar extraction. The 27-year-old Caucasian male patient presented a symmetric face with a straight profile, hyperdivergent growth pattern, molar and cuspid Class III relation, and an anterior crossbite as well as a mild crowding on cuspids area, in both upper and lower arches and a tendency to posterior crossbite. The treatment was performed by the use of Haas expansion appliance followed by an initial alignment and leveling of the upper and lower arches with a fixed edgewise appliance, extraction of lower teeth aiming the correction of the incisors proclination and end the treatment with a Class I molar relationship. It resulted in a significant change in the patient’s profile, dentoalveolar Class III correction, upper arch expansion, leveling and alignment of the upper and lower arches, and improvement of tipping of the upper and lowers incisors. In cases of a dentoalveolar compensation in well positioned bone bases the treatment with fixed appliances is an alternative and extraction of lower teeth is considered.

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Treatment of Class III Malocclusion in an Adolescent with Banded RPE/Face Mask and Self-Ligating System

UI Proceedings on Health and Medicine ◽

10.7454/uiphm.v1i0.13 ◽

2017 ◽

Vol 1 ◽

Author(s):

Dwita Pratiwi Dwita Pratiwi ◽

Benny Mulyono Soegiharto

Keyword(s):

Orthodontic Treatment ◽

Face Mask ◽

Class I ◽

Adolescent Patient ◽

Class Iii ◽

Class Iii Malocclusion ◽

Facial Profile ◽

The Right ◽

Cervical Vertebral Maturation ◽

Dental Malocclusion

<p>This case report describes the treatment of a 12-years-old female with a Class III skeletal profile and dental malocclusion. The clinical examination showed concave profile, class III dental relationship, buccal crossbite on the right side, and mild crowding. The cervical vertebral maturation analysis showed the patient was on the CS3 stage. The class III malocclusion was treated with combination of banded rapid palatal expander and face mask followed by non-extraction orthodontic treatment with self-ligating system. Banded rapid palatal expander and face mask were used to improve the skeletal discrepancy. Class I maxilla-mandibular relationship was achieved along with class I molar, incisor, and canine relationship. The buccal crossbite and mild crowding were corrected, the overbite and overjet were normal, and the facial profile was improved. This case demonstrates a good result of a class III malocclusion treatment in an adolescent patient with banded rapid palatal expander/face mask and self-ligating system.</p>

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Class III treatment using facial mask: Stability after 10 years

Dental Press Journal of Orthodontics ◽

10.1590/2176-9451.19.5.123-135.bbo ◽

2014 ◽

Vol 19 (5) ◽

pp. 123-135 ◽

Cited By ~ 4

Author(s):

Adilson Luiz Ramos

Keyword(s):

Face Mask ◽

Mixed Dentition ◽

Class Iii ◽

Class Iii Malocclusion ◽

Mandibular Growth ◽

Long Term Stability ◽

Fixed Appliances ◽

Dentofacial Orthopedics ◽

Class Iii Treatment

Early Class III malocclusion treatment may not have long-term stability due to mandibular growth. Although some features of this malocclusion point to a better prognosis, it is practically impossible for the orthodontist to foresee cases that require new intervention. Many patients need retreatment, whether compensatory or orthodontic-surgical. The present study reports the case of a Class III patient treated at the end of the mixed dentition with the use of a face mask followed by conventional fixed appliances. The case remains stable 10 years after treatment completion. It was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO.

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