Orthopedic Treatment Outcomes in Class III Malocclusion

Toffol, Laura De; Pavoni, Chiara; Baccetti, Tiziano; Franchi, Lorenzo; Cozza, Paola

doi:10.2319/030207-108.1

Cited by 137 publications

(113 citation statements)

References 29 publications

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“…16 Retrospective controlled studies, have some benefit until results from prospective studies become available 17 and information from these studies have been included in orthodontic systematic reviews on Class III treatment and lingual arch space maintenance. 18,19 Although RCTs and controlled clinical trials (CCTs) have been considered in a previous review, 20 until now it would appear that no review has addressed all of the prospective and retrospective evidence regarding effectiveness of orthodontic treatment and its stability for II/2M.…”

Section: Introductionmentioning

confidence: 99%

Treatment and stability of Class II Division 2 malocclusion in children and adolescents: A systematic review

Millett

Cunningham

O’Brien

et al. 2012

American Journal of Orthodontics and Dentofacial Orthopedics

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Objectives: To evaluate the evidence with regard to the effectiveness and stability of orthodontic treatment interventions for Class II division 2 malocclusion (II/2M) in children and adolescents.Design: Systematic review conducted according to the PRISMA statement.Methods: The Cochrane Oral Health Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched to November 2011. Relevant conference abstracts were also screened. No language restrictions were applied. Inclusion criteria were: clinical studies with > 20 II/2M subjects where comparisons were made with an untreated II/2 M group or another treated II/2 M group or neither. For included studies ranked best on the hierarchy of evidence, assessments of methodological quality and risk of bias were undertaken. Abstracts and, when appropriate, full papers were examined independently by two investigators. Disagreements were resolved through discussion.Outcomes: Treatment changes and/or stability with or without retainers using the following measures: skeletal, soft tissue, dental, occlusal changes, gingival health, TMJ status and/or related muscular activity or quality of life.Results: Of the 322 studies identified in the search, 20 met the final inclusion criteria. All were at high risk of bias.Conclusions: Highly biased evidence exists with regard to management and stability of II/2 M. Guidelines are proposed based on current evidence.

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Section: Introductionmentioning

confidence: 99%

Treatment and stability of Class II Division 2 malocclusion in children and adolescents: A systematic review

Millett

Cunningham

O’Brien

et al. 2012

American Journal of Orthodontics and Dentofacial Orthopedics

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“…[10][11][12][13] These results were often confirmed in controlled trials that usually included combined maxillary expansion and FM therapy. [14][15][16][17][18][19][20][21] Clinical studies have also shown variable effects of maxillary protraction therapy on the amount of mandibular growth, with a tendency toward Class III relapse when the mandible rotated downward and backward during treatment. [17][18][19]21 Only a few studies dealing with the effects of orthopedic therapy of Class III malocclusion included posttreatment observations to evaluate relapse tendencies after active therapy.…”

Section: Introductionmentioning

confidence: 99%

“…15,[17][18][19][20][21][22][23][24][25] Also, few trials incorporated an untreated control sample of Class III subjects followed longitudinally. 16 Predictive variables for satisfactory long-term outcomes of Class III early treatment can be identified in the overcorrection of overjet (OJ) 15,18 and the appropriate control of vertical dentoalveolar height to prevent an unfavorable clockwise rotation of the mandible. [19][20][21] Bite-blocks (BB) have demonstrated beneficial therapeutic effects in subjects with dentoskeletal open-bite tendency, since they reduce extrusion of the posterior teeth and allow autorotation of the mandible to produce bite closure.…”

Section: Introductionmentioning

confidence: 99%

Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in Class III malocclusion

Cozza¹,

Baccetti²,

Mucedero³

et al. 2010

American Journal of Orthodontics and Dentofacial Orthopedics

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Introduction:In this cephalometric investigation, we analyzed the treatment and posttreatment effects of an orthopedic protocol for Class III malocclusion consisting of a facial mask combined with a removable biteblock appliance. Methods: The treated sample consisted of 22 Class III patients treated with the facial mask and bite-block protocol before the pubertal growth spurt (mean age, 8.9 6 1.5 years). Treated subjects were evaluated after facial mask and bite-block therapy and at a posttreatment observation in absence of retention. The treated group was compared with a matched control group of 12 untreated Class III subjects. All treated and control subjects were postpubertal at the final observation. Significant differences between the treated and control groups were assessed with the Mann-Whitney U test (P \0.05). Results: Both angular and linear sagittal measurements of the maxilla showed significant improvements during active treatment. Significant improvements of SNA angle, ANB angle, overjet, and molar relationship remained stable during the posttreatment period. No significant effect was found in the mandibular skeletal measures. No significant protraction of the maxillary incisors or retraction of the mandibular incisors was observed. Conclusions: A bite-block appliance in the mandibular arch with a facial mask enabled effective control of mandibular rotation with progressive closure of the gonial angle. This added to the favorable maxillary outcomes of the treatment protocol. (Am J Orthod Dentofacial Orthop 2010;138:300-10)

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“…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.…”

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confidence: 99%

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

Masucci

Franchi

Defraia

et al. 2011

American Journal of Orthodontics and Dentofacial Orthopedics

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Introduction: The aim of this prospective controlled study was to evaluate the long-term effects of rapid maxillary expansion and facemask therapy in Class III subjects. Methods: Twenty-two subjects (9 boys, 13 girls; mean age, 9.2 years 6 1.6) with Class III disharmony were treated consecutively with rapid maxillary expansion and facemask therapy followed by fixed appliances. The patients were reevaluated at the end of the 2-phase treatment (mean age, 14.5 years 6 1.9) and then recalled about 8.5 years after the end of rapid maxillary expansion and facemask treatment (mean age, 18.7 years 6 2.1). Two groups of controls with untreated Class III malocclusion were used for statistical comparisons of the short-term and long-term intervals. Statistical comparisons were performed with the Mann-Whitney U test. Results: In the long term, no significant differences in maxillary changes were recorded, whereas the treatment group showed significantly smaller increases in mandibular protrusion. The sagittal maxillomandibular skeletal variables maintained significant improvements in the treatment group vs the control groups. Conclusions: In the long term, rapid maxillary expansion and facemask therapy led to successful outcomes in about 73% of the Class III patients. Favorable skeletal changes were mainly due to significant improvements in the sagittal position of the mandible. (Am J Orthod Dentofacial Orthop 2011;140:493-500)

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Orthopedic Treatment Outcomes in Class III Malocclusion

Cited by 137 publications

References 29 publications

Treatment and stability of Class II Division 2 malocclusion in children and adolescents: A systematic review

Treatment and stability of Class II Division 2 malocclusion in children and adolescents: A systematic review

Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in Class III malocclusion

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

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