Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances

Stability of rapid maxillary expansion and facemask therapy: A long-term controlled study

“…No significant changes were recorded in the vertical skeletal or dental relationships. These short-term postpubertal treatment outcomes were similar to those reported by Westwood et al, 4 who implemented a comparable methodology of investigation.…”

“…26 When individual patient data were analyzed, we found that over 70% of the patients (16 of 22) could be considered clinically successful in the long term, whereas less than 30% of them (6 of 22) were unsuccessful at T3 because of relapse in the occlusal relationships. The prevalence rate for the long-term success of RME/ FM therapy of Class III malocclusion appears as a favorable result, and it is similar to the success rates reported in other studies on orthopedic Class III treatment that included a posttreatment interval (76% according to Westwood et al 4 ; 75% according to Ngan et al 9 and Wells et al 6 ; 67% according to H€ agg et al 5 ).…”

“…4,22 From T1 to T3, the treatment group did not show a significant amount of closure of the gonial angle (a growth modification that has been advocated as a favorable mechanism to limit linear increases of the mandible along Co-Gn 23 ) or any significant improvement in the sagittal position of the maxilla, as described by Westwood et al 4 and Pangrazio-Kulbersh et al 22 However, Franchi et al 7 showed that both of these craniofacial changes are induced by early, prepubertal orthopedic treatment of Class III disharmony, but they are not associated with later treatment, during or after puberty. Our study included patients who underwent orthopedic treatment before puberty (14 patients) and at puberty (8 patients).…”

“…First, a significant tendency for the reestablishment of the Class III growth pattern has been widely demonstrated after active protraction therapy, with special emphasis during the pubertal growth spurt. 4,[8][9][10] Second, pubertal growth tends to last longer in Class III subjects compared with Class I subjects. 11 On the other end, long-term observations at the end of active craniofacial growth are available for different orthopedic and orthodontic approaches: chincup therapy, with favorable short-term changes often not maintained at the end of growth, 12 and mandibular cervical headgear, with greater long-term stability of favorable mandibular modifications.…”

“…1,2 The literature includes many articles on the short-term results of RME/FM therapy in growing subjects with Class III disharmonies, as described in a recent systematic review. 3 Several studies have also evaluated the outcomes of the orthopedic treatment protocol at postpubertal observations after fixed appliance therapy, either with 4 or without 5,6 untreated Class III controls. Both short-term and postpubertal observations indicated a fair-to-good effectiveness of RME/FM therapy, with about 70% to 80% of the patients showing favorable results after puberty.…”