scholarly journals Early treatment of Class III malocclusion with a tandem traction bow appliance

2016 ◽  
Vol 6 ◽  
pp. 228-231
Author(s):  
Sneha Basaveshwar Valgadde ◽  
Kishor Chougule

Since Class III malocclusion is progressive in nature, the facial growth of Class III malocclusion worsens with age. Class III malocclusion is associated with a deviation in the sagittal relationship of the maxilla and the mandible, characterized by a deficient maxilla, retrognathic mandible, or a combination of both. The early orthopedic treatment of Class III malocclusions, at the end of primary dentition or the beginning of mixed dentition, prior to growth spurt, allows the accomplishment of successful results, providing facial balance, modifying the maxillofacial growth and development, and in many instances, preventing a future surgical treatment by increasing the stability. Many treatment approaches can be found in the literature regarding orthopedic and orthodontic treatment of Class III malocclusion, including intra- and extra-oral appliances. The major problem with extraoral anchorage has been of patient compliance due to its physical appearance. The case report presents an intraoral modified tandem appliance for maxillary protraction that has been used clinically to achieve successful results without relying much on patient co-operation.

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Zeinab Azamian ◽  
Farinaz Shirban

It is very difficult to diagnose and treat Class III malocclusion. This type of malocclusion involves a number of cranial base and maxillary and mandibular skeletal and dental compensation components. In Class III malocclusion originating from mandibular prognathism, orthodontic treatment in growing patients is not a good choice and in most cases orthognathic surgery is recommended after the end of growth. Approximately 30–40% of Class III patients exhibit some degree of maxillary deficiency; therefore, devices can be used for maxillary protraction for orthodontic treatment in early mixed dentition. In cases in which dental components are primarily responsible for Class III malocclusion, early therapeutic intervention is recommended. An electronic search was conducted using the Medline database (Entrez PubMed), the Cochrane Collaboration Oral Health Group Database of Clinical Trials, Science Direct, and Scopus. In this review article, we described the treatment options for Class III malocclusion in growing patient with an emphasis on maxillary protraction. It seems that the most important factor for treatment of Class III malocclusion in growing patient is case selection.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Snigdha Pattanaik ◽  
Sumita Mishra

Class III malocclusion is one of the most difficult problems to treat in the mixed dentition. It has a multifactorial etiology involving both genetic and environmental causes. The dental and skeletal effects of maxillary protraction with a facemask are well documented in several studies. Although treatment in the late mixed or early permanent dentition can be successful, results are generally better in the deciduous or early mixed dentition. The following case shows early treatment of a young patient with severe sagittal and transverse discrepancy of the maxilla and mandible, using a facemask.


2020 ◽  
Vol 9 (9) ◽  
pp. 3015 ◽  
Author(s):  
Golnar Havakeshian ◽  
Vasiliki Koretsi ◽  
Theodore Eliades ◽  
Spyridon N. Papageorgiou

The aim of this systematic review is to compare the effect on the upper airways of orthopedic treatment for skeletal Class III malocclusion with untreated controls. Nine databases were searched up to August 2020 for randomized or nonrandomized clinical trials comparing orthopedic Class III treatment (facemask or chin-cup) to untreated Class III patients. After duplicate study selection, data extraction, and risk of bias assessment (Risk Of Bias In Non-randomized Studies-of Interventions [ROBINS-I]), random-effects meta-analyses of Mean Differences (MDs)/Standardized Mean Differences (SMD) and 95% Confidence Intervals (CIs) were performed, followed by the Grading of Recommendations Assessment, Development and Evaluation assessment evidence-quality. A total of 10 papers (9 unique nonrandomized studies) with 466 patients (42.7% male; average age 9.1 years) were finally included. Limited evidence indicated that compared to normal growth, maxillary protraction with facemask was associated with increases in total airway area (n = 1; MD = 222.9 mm2; 95% CI = 14.0–431.7 mm2), total nasopharyngeal area (n = 4; SMD = 1.6; 95% CI = 1.2–2.0), and individual airway dimensions (upper-airway MD = 2.5 mm; lower-airway MD = 2.1 mm; upper-pharynx MD = 1.6 mm; lower-pharynx MD = 1.0 mm; all n = 6). Subgroup/meta-regression analyses did not find any significant effect-modifiers, while the results were retained 2–5 years postretention. Our confidence in these estimates was, however, very low, due to the inclusion of nonrandomized studies with methodological issues. Limited data from 2 chin-cup studies indicated smaller benefits on airway dimensions. Existing evidence from controlled clinical studies on humans indicates that maxillary protraction for skeletal Class III treatment might be associated with increased airway dimensions, which are, however, mostly minor in magnitude.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
V. Paoloni ◽  
F. C. De Razza ◽  
L. Franchi ◽  
P. Cozza

Abstract Background To evaluate morphologic differences between class III malocclusion success and failure treatment subjects in order to identify which variables are more predictive for long-term stability in early orthopedic treatment. In this retrospective study, 31 patients were enrolled from the Department of Orthodontics (Rome Tor Vergata). Inclusion criteria were as follows: white ancestry, class III malocclusion, mixed dentition, cervical stage (CS) 1-2, no pseudo-class III. Pre-treatment radiographic and cast records were collected. Each patient underwent rapid maxillary expansion/facial mask/bite block (RME/FM/BB) orthopedic treatment until correction. At T1 (permanent dentition, CS4), records were recollected. According to treatment stability, relapse group (RG, 19) and success group (SG, 12) were identified. Sagittal and vertical cephalometric and digital cast measurements were performed. Student’s t tests were used for statistically significant differences inter and intra groups. For discriminant analysis, relapse or success status was added to each patient’s T0 data. Results At T0, RG showed larger upper anterior transversal width (p = 0.0266), while at T1 the upper anterior length was shorter than SG (p = 0.0028). Between T1 and T0, both groups showed larger upper anterior and posterior transversal widths. SG had greater upper anterior (p = 0.0066) and posterior (p = 0.449) sagittal length. RG presented larger lower anterior (p = 0.0012) and posterior (p = 0.0002) transversal widths, while there were no differences in SG lower arch. Discriminant analysis provided two predictive variables with an accuracy of 80.6%: upper anterior length and upper posterior length. Conclusion A shorter and wider maxilla could be a predisposing factor for relapse and failure of the early orthopedic treatment of class III malocclusion patients. The absence of mandibular changes could be predictable for treatment success.


2012 ◽  
Vol 17 (6) ◽  
pp. 41-51 ◽  
Author(s):  
Fernando Antonio Gonçalves ◽  
Vânia Célia Vieira de Siqueira

OBJECTIVE: To evaluate the stability of bimaxillary surgery in patients with skeletal malocclusion, with the use of rigid internal fixation. METHODS: Lateral cephalograms from 20 patients, 11 males and 9 females, mean age of 26 years and 1 month, were evaluated before surgery, immediately post-operative and at least 6 months after surgery. Nineteen cephalometric measurements were evaluated, and the results were statistically analyzed by means of the Student's t test and the Kruskal-Wallis test. RESULTS: The Le Fort I maxillary advancement surgery showed almost no relapse. There was lack of stability of mandibular setback, with relapse of 37.33% on point B, due to counterclockwise rotation of the mandible between post-operative periods, occurred by better intercuspation after surgery and muscle adaptation. The results showed the same tendencies for both genders. CONCLUSION: It was concluded that on the bimaxillary surgery treatment of Class III malocclusion, the maxillary surgery was very stable, but the mandibular setback recurred. No statistical differences were found in surgical stability between genders.


2019 ◽  
Vol 9 ◽  
pp. 59-64
Author(s):  
Ramesh Agrawal ◽  
Dolly P. Patel ◽  
Bhagyashree B. Desai

The current paper depicts the challenges faced during the treatment of a complicated case of mandibular condylar head fracture, facial asymmetry, and centric relation-centric occlusion (CR-CO) discrepancy along with Class III malocclusion. A 20-year-old female reported with the chief complaint of difficulty in chewing and concern with her appearance due to deviated jaw and had a history of trauma over chin region. The clinical and radiographic examination revealed significant facial asymmetry with long face, right-sided deviation of the mandible, fractured condyle, CR-CO discrepancy, cross- bite with Class III malocclusion, and a missing mandibular single incisor along with non-vital 21 and 22. She was treated with 0.022 MBT appliance along with guiding plane for CR-CO correction followed by asymmetric bilateral sagittal split osteotomy and differential set back on the right and left sides and finally rigid fixation. A good facial profile and functional occlusion were achieved and non-vital 21 and 22 were esthetically rehabilitated with PFM crowns. The stability of surgical as well as orthodontic corrections was excellent and appreciable in the records obtained 2-year post-treatment. When faced with mutilated malocclusion, with multiple problems, sequential correction of functional malocclusion with dental decompensation followed by skeletal correction with surgical approach has yielded a appreciable facial correction with good stability showing 2-year post-treatment follow-up.


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