Non-extraction camouflage treatment of skeletal class III malocclusion

@#Class III malocclusion can be defined as a skeletal facial deformity that is characterized by a forward mandibular position with respect to the cranial base and or the maxilla. We present a case of a 15-year-old man with skeletal Class III malocclusion who was treated with non-extraction orthodontic camouflage treatment using an orthodontic conventional technique. A fixed appliance, straight wire appliance (SWA) technique was used with a non-extraction treatment plan. Treatment was accompanied by intermaxillary Class III elastics. The total duration of active treatment was 23 months. There was a significant improvement in his occlusion, smile esthetics, and soft tissue profile pattern. Orthodontic camouflage can be considered an effective therapy for correcting milder cases of skeletal Class III malocclusion.

Nonsurgical orthodontic treatment in an adult with skeletal class III malocclusion using passive self-ligating system: A case report

@#Skeletal Class III malocclusion treatment is complex, especially when jaw deviations are serious. Camouflage treatment of skeletal Class III malocclusion improves prognosis with a slight-to-moderate functional shift. This report presents the case of a 23-year-old male with poor facial esthetics associated with chin protrusion and an uncomfortable bite. He had a concave profile, unfavorable incisor displays, protrusive lower lip, and strained lip closure. Camouflage therapy with a passive self-ligating (PSL) system through the anterior teeth of the maxilla protraction and arch expansion was used. After 14 months of treatment, the overjet outcome was positive. The teeth were arched, asymmetry was addressed, the convex profile and no deviation occurred when the jaw was closed. Factors in using the PSL system were low friction between the bracket and archwire, torque selection, and the significant dental arch expansion ability. The PSL system is an appropriate option in treating adults with skeletal Class III malocclusion to achieve a normal occlusion and a pleasant facial profile.

Multi?Disciplinary Orthodontic Camouflage Treatment of a Severe Skeletal Class III Malocclusion with 1 Year Follow-Up – A Case Report

Rationale: Orthodontic camouflage serves its purpose in treating mild to moderate skeletal dysplasia and in conditions where the patient is reluctant to opt for orthognathic surgery or when it is contraindicated. Patient Concerns: A 22?year?old male was concerned about his irregular teeth. Diagnosis: Angle’s dentoalveolar class III malocclusion on class III skeletal on an average mandibular plane angle with anterior crossbite, deep bite, crowding in maxillary and mandibular anteriors, proclined maxillary anteriors and retroclined mandibular anteriors with reverse overjet and congenitally missing 12, 22, palatally impacted 13 and retained deciduous 63 and palatally placed 23. Treatment: Orthodontic camouflage with a multi?disciplinary approach. Outcome: Optimal functional and dentofacial aesthetics were achieved by 22 months. Take?Away Lesson: The limitations of camouflage must be kept in mind and explained to the patient. The biomechanics need to be customized and integrating different specialties helps maximize the treatment benefits.

Effects of different force directions of intra-oral skeletally anchored maxillary protraction on craniomaxillofacial complex, in Class III malocclusion: a 3D finite element analysis

ABSTRACT Introduction: The intra-oral skeletally anchored maxillary protraction (I-SAMP) has been found to be an effective treatment for skeletal Class III malocclusion. Objective: This in-silico study explored the influence of different force directions of intra-oral skeletally anchored Class III elastics on the changes in craniomaxillofacial complex, using finite element analysis. Methods: A 3-dimensional (3D) finite element model of the craniomaxillofacial bones including circummaxillary sutures was constructed with high biological resemblance. A 3D assembly of four miniplates was designed and fixed on the maxilla and mandible of the finite element model. The model was applied with 250g/force at the miniplates at three angulations (10°, 20°, and 30°) from the occlusal plane, to measure stress and displacement by using the ANSYS software. Results: The zygomaticotemporal, zygomaticomaxillary, and sphenozygomatic sutures played significant roles in the forward displacement and counterclockwise rotation of maxilla and zygoma, irrespective of the angulation of load application. The displacements and rotations of the zygomatico-maxillary complex decreased gradually with an increase in the angle of load application between miniplates from 10° to 30°. The mandible showed negligible displacement, with clockwise rotation. Conclusions: The treatment effects of I-SAMP were corroborated, with insight of displacement patterns and sutures involved, which were lacking in the previously conducted 2D and 3D imaging studies. The prescribed angulation of skeletally anchored Class III elastics should be as low as possible, since the displacement of zygomatico-maxillary complex increases with the decrease in angulation of the elastics.

RESUMO Introdução: A protração maxilar com ancoragem esquelética intrabucal (I-SAMP) tem sido considerada um tratamento efetivo para a má oclusão esquelética de Classe III. Objetivo: O presente estudo in silico avaliou, usando análise de elementos finitos, a influência de diferentes direções da força dos elásticos Classe III com ancoragem esquelética intrabucal nas mudanças no complexo craniomaxilofacial. Métodos: Um modelo de elementos finitos tridimensional (3D) dos ossos craniomaxilofaciais, incluindo as suturas circum-maxilares, foi construído, com alta semelhança biológica. Uma montagem 3D de quatro miniplacas foi projetada e fixada na maxila e na mandíbula do modelo de elementos finitos. O modelo foi aplicado com o uso de 250g/força nas miniplacas em três angulações (10°, 20° e 30°) em relação ao plano oclusal, para medir as tensões e os deslocamentos, usando o programa ANSYS. Resultados: As suturas zigomaticotemporal, zigomaticomaxilar e esfenozigomática desempenharam um papel significativo no deslocamento para anterior e na rotação anti-horária da maxila e do zigoma, independentemente da angulação na aplicação da força. Os deslocamentos e as rotações do complexo zigomático-maxilar diminuíram gradualmente com o aumento de 10° para 30° no ângulo de aplicação da força entre as miniplacas. A mandíbula apresentou deslocamento irrelevante, com rotação no sentido horário. Conclusões: Os efeitos do tratamento com I-SAMP foram corroborados, com um vislumbre dos padrões de deslocamento e das suturas envolvidas, que não existiam nos estudos com imagens 2D e 3D realizados anteriormente. A angulação dos elásticos Classe III ancorados esqueleticamente deve ser a menor possível, visto que o deslocamento do complexo zigomático-maxilar aumenta com a redução no ângulo dos elásticos.

Clase III esqueletal ­ cuando todas las estrategias son insuficientes: reporte de un caso clínico / Skeletal class III - when all strategies are insufficient: report of a clinical case

Desde la antigüedad la belleza y la armonía facial han sido objetivos que tanto pintores como escultores, médicos y las personas tratan de lograr. Los rostros han sido estereotipados y es así como las caras proporcionadas tanto en alto como en ancho con perfiles que son rectos o levemente convexos son los que se asocian a bondad, generosidad, personas con luz interior, princesas y son las "buenas de las películas". Pero ¿qué sucede con aquellos rostros cóncavos, con tercios inferiores ya largos o cortos?… a ellos les ha tocado la peor parte, son los malos, los oscuros, los "villanos de las películas". Objetivos La finalidad de este trabajo es acercar a los colegas ortodoncistas una opción de tratamiento en clase III esqueletal, cuando el camuflaje ortodóncico no alcanza para resolver el crecimiento alterado entre el maxilar superior y el maxilar inferior (AU)

Beauty and facial harmony have been, since the beginning of humanity, a target for artists, painters, sculptores, and even people and doctors to accomplish. There is a stereotype of beauty: faces with proportional dimensions both in height and length, with straight profiles or somehow convex are associated with kindness, generosity and inner beauty. We can see this in movies where the heroes, the princesses, the "good guys" are portrayed with these types of faces. And what happens with people with concave faces, long or short inferior thirds? They are doomed to be the evil, the dark and "the villains" (AU)

Corrección de una clase III esqueletal con anclaje óseo en paciente en crecimiento: Reporte de caso / Skeletal class III correction in growing patient with bone anchorage: CaseReport

Antecedentes: La clase III esqueletal, es una deformidad dentofacial donde el tercio inferior de la cara es más prominente, el tratamiento se decide según la etiología y la edad del paciente; si se encuentra en crecimiento la malformación puede ser tratada con un protocolo interceptivo y si es posible evitar la cirugía ortognática a futuro. Objetivo: Mejorar la clase esqueletal, descruzar la mordida u obtener mordida borde a borde, mejorar la posición del labio superior y evaluar el comparativo inicial-final de SNA y ANB. Reporte de caso:Paciente masculino de 13 años, sin antecedentes personales patológicos o familiares reportados; presenta clase III esqueletal responsiva bimaxilar, crecimiento vertical, clase molar I y canina III; fue tratado con el protocolo de mini placas BAMP (bone anchored maxillary protraction) por sus siglas en inglés, elásticos intermaxilares y un paladar con pistas planas. Resultados:La fase ortopédica duro cinco meses y se logró mordida borde a borde y clase I esqueletal. Discusión: Se obtuvieron resultados con el uso de mini implantes sin anclaje extraoral en menos tiempo a comparación de otros métodos que tienen que ser usados por 9-12 meses.Conclusión:El protocolo BAMP puede ser usado en pacientes en crecimiento sin máscara facial para corregir la clase III esqueletal.

Background: Skeletal class III is a dentofacial deformity where the lower third ofthe face is more prominent. The treatment is decided according to the etiology and age of the patient; If the patient is in growing, the malformation can be treated with an interceptive protocol and if possible, avoid a orthognathic surgery in the future. Objective: Improve the skeletal class, uncross the bite or obtain an edge-to-edge bite, improve the position of the upper lip and compare the initial-final relationship of ANS and ANB.Case report:13-year-old male patient, with no reported pathological or family history; presents skeletal class III, vertical growth, molar class I and canine III; he was treated with the protocol of mini BAMP (bone anchored maxillary protraction) plates, intermaxillary elastics and a palate with flat tracks. Results:The orthopedic phase lasted five months and an edge-to-edge bite and skeletal class I were achieved.Discussion:Results were obtained with the use of mini plates without extraoralanchorage in less time compared to other methods that have to be used for 9-12 months. Conclusion: The BAMP protocol can be used in growing patients without a face mask to correct skeletal class III.

Camouflage Treatment of Skeletal Class III Malocclusion with Anterior Crossbite in Adults: A Case Series

In the current scenario, different treatment modalities exist when orthodontic camouflage needs to be done in patients with mildor moderate skeletal Class III malocclusions. Recent advances such as temporary anchorage devices increased the scope ofcamouflage treatment. This series of cases describes the non-surgical management of skeletal Class III malocclusion usingtreatment mechanics, which efficiently improve the functional occlusion and esthetic requirements of the patient.

Implant treatment on anterior cross-bite of a patient who had orthognathic surgery 20 years ago / 대한치과보철학회지

Orthognathic surgery of skeletal Class III malocclusion improves oral function and facial appearance. The greater amount of skeletal discrepancy, the greater amount of teeth movement required for decompensation, and this often causes pathological changes in periodontal tissue especially in lower anterior dentition. We made a Top-Down treatment plan with personalized analysis using Face Hunter, Plane System and ARCUS Digma II, in order to resolve severe mobility and cross-bite of lower anterior teeth for 49-year-old female patient who had undergone orthognathic surgery 20 years ago due to skeletal Class III malocclusion and mandibular prognathism. Lower anterior teeth were extracted and alveoloplasty was done. After healing of the wound, immediate loading was conducted immediately after implant placement. Final restorations were fabricated Zirconia using CAD/CAM, and inserted intraorally screw-retained type. During 6-month follow-up, no abnormal episodes of restorations were observed, and obtained satisfactorily both of functional and esthetic outcomes.

Effect of Developmental Disorders of Maxillary First Molars on Orofacial Morphology / 대한소아치과학회지

This study was aimed to evaluate orofacial morphologies on the cases of developmental disorders of maxillary first molars.Panoramic radiographs, lateral cephalographs, and clinical photos of 2983 children who attended the Pediatric Dental Clinic of Pusan National University Dental Hospital from 2006 to August 2017 were assessed retrospectively. 34 patients were selected whose maxillary first molars were missed or developmentally delayed unilaterally or bilaterally. Demirjian' s method was used for estimating dental age, then which was compared to chronologic age of children. Parameters expressing skeletal and dentoalveolar disharmony were checked and compared with control. Additionally, occlusion relationship was evaluated.Maxillary dental age was significantly delayed compared to chronologic age. Several parameters which show skeletal open-bite tendency and skeletal class III malocclusion with maxillary retrusion were statistically significant. Anterior crossbite and edge-bite were expected in most of these cases, but compensation by occlusion and soft tissue was also verified which might mask skeletal class III tendency.Congenital missed or developmentally delayed maxillary first molars might be related with declined growth of maxilla. If developmental disorders of maxillary first molars were verified during clinical examination, careful monitoring of orofacial growth was necessary during puberty and timed orthopedic and orthodontic intervention were considered.

Quick correction of a skeletal class III maloclussion in primary dentition with face mask plus rapid maxillary expansion therapy / Corrección rápida de una maloclusión esquelética clase III en dentición primaria con máscara facial más terapia rápida de expansión maxilar

Abstract Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.

Resumen La clase III esquelética es una maloclusión caracterizada por mordida cruzada anterior como resultado de una discrepancia esquelética de la base maxilar y mandibular, que implica desarmonía craneofacial y del perfil. El tratamiento de elección para niños con maloclusión clase III esquelética con mandíbula maxilar y/o prognática es el uso de dispositivos que estimulan el crecimiento y el movimiento anterior del hueso maxilar y/o restringen el crecimiento excesivo de la mandíbula. El tratamiento ortopédico que consiste en una máscara facial con expansión maxilar rápida (EMR) produce resultados en un período de tiempo más corto. El propósito de este artículo es revisar una corrección rápida de la maloclusión de clase III esquelética en la dentición primaria mediante el uso de una máscara facial más terapia de expansión maxilar rápida en un paciente masculino de 5 años debido a una combinación de maxilar retruido y mandíbula prominente, en dentición primaria, que fue tratada con una mascarilla Petit junto con un dispositivo intraoral unido con bloques de mordida. Los primeros resultados evidentes fueron una rotación en sentido horario de la mandíbula, un overjet positivo de 3 mm, una sobremordida correcta, una relación canina de Clase I y un plano terminal de descarga bilateral. Después de discutir el presente informe de caso clínico y la literatura publicada relacionada, concluimos que las maloclusiones de clase III esqueléticas deberían tratarse tan pronto como se reconozcan los primeros signos clínicos de crecimiento craneofacial anormal, durante los primeros años de vida.

Morphological changes of skeletal class III malocclusion in mixed dentition with protraction combined activities / Cambios morfológicos en maloclusión de la clase esquelética III en dentición mixta con actividades combinadas de protracción

The objective of the study was to investigate the morphological changes of skeletal class III malocclusion in mixed dentition with light force protraction combined activities. Randomly selected 30 cases of orthodontics in Shanxi Medical University orthodontics patients (ages: 6-10 years) of the lateral cephalograms. Using the oral maxillary casting type of pre-traction device, according to the condition of maxillary dentition to select the corresponding activities of the movable expansion appliance, each side of the force of about 150-200 g, requiring patients to wear 10-12 hours a day, the appliance should be removed after reaching normal occlusion. The correlation cephalometric profile of the cranial lateral radiographs before and after orthodontic treatment was measured. All patients with skeletal class III malocclusion were improved, concave type became direct type, measurements SNA, ANB, A-Ptm, MP-SN, ANS-Me/N-Me increased, maxillary advancement and reconstruction are more obvious; mandible rotates clockwise; the increase of lip inclination of anterior teeth compensatory changes, lower anterior tooth inclination changes smaller; upper lip forward, nasolabial angle decreased, improved appearance significantly. Light force protraction combined activities can make the mixed dentition of skeletal class III malocclusion in patients with significant improvement in profile appearance.

El objetivo de este estudio fue investigar los cambios morfológicos de la maloclusión clase esquelética III, en la dentición mixta, con actividades combinadas de protracción de la fuerza ligera. Se seleccionaron aleatoriamente 30 casos de ortodoncia en pacientes de ortodoncia de la Universidad Médica de Shanxi (edades: 6-10 años) a partir de cefalogramas laterales, utilizando el tipo de dispositivo de pretracción de vaciado maxilar oral, de acuerdo con la condición de la dentición maxilar para seleccionar las actividades correspondientes del dispositivo de expansión móvil, cada lado con fuerza de alrededor de 150-200 g, requiriendo que los pacientes los utilizaran de 10 a 12 horas al día. El dispositivo debía ser retirado después de alcanzar la oclusión normal. Se midió el perfil cefalométrico de correlación de las radiografías laterales craneales, antes y después del tratamiento ortodóncico. Se observó mejoramiento en todos los pacientes con maloclusión de clase esquelética. Las mediciones SNA, ANB, APtm, MP-SN, ANS-Me / N-Me aumentaron, el avance y la reconstrucción maxilar fueron los cambios más significativos; la mandíbula giró en el sentido de las agujas del reloj, se observó un aumento de la inclinación labial de los dientes anteriores. Fue reducida la inclinación anterior del diente inferior, el ángulo nasolabial disminuyó y en general mejoró significativamente la apariencia. Las actividades combinadas de protrusión de la fuerza radiante pueden llevar a una mejora signficativa en el perfil de pacientes con dentición mixta de maloclusión clase III.

Assessment of lower incisor alveolar bone width using cone-beam computed tomography images in skeletal Class III adults of different vertical patterns / 대한치과교정학회지

OBJECTIVE: This study was performed to investigate the alveolar bone of lower incisors in skeletal Class III adults of different vertical facial patterns and to compare it with that of Class I adults using cone-beam computed tomography (CBCT) images. METHODS: CBCT images of 90 skeletal Class III and 29 Class I patients were evaluated. Class III subjects were divided by mandibular plane angle: high (SN-MP > 38.0°), normal (30.0°< SN-MP < 37.0°), and low (SN-MP < 28.0°) groups. Buccolingual alveolar bone thickness was measured using CBCT images of mandibular incisors at alveolar crest and 3, 6, and 9 mm apical levels. Linear mixed model, Bonferroni post-hoc test, and Pearson correlation analysis were used for statistical significance. RESULTS: Buccolingual alveolar bone in Class III high, normal and low angle subjects was not significantly different at alveolar crest and 3 mm apical level while lingual bone was thicker at 6 and 9 mm apical levels than on buccal side. Class III high angle group had thinner alveolar bone at all levels except at buccal alveolar crest and 9 mm apical level on lingual side compared to the Class I group. Class III high angle group showed thinner alveolar bone than the Class III normal or low angle groups in most regions. Mandibular plane angle showed negative correlations with mandibular anterior alveolar bone thickness. CONCLUSIONS: Skeletal Class III subjects with high mandibular plane angles showed thinner mandibular alveolar bone in most areas compared to normal or low angle subjects. Mandibular plane angle was negatively correlated with buccolingual alveolar bone thickness.

Cone-beam computed tomography analysis of transverse dental compensation in patients with skeletal Class III malocclusion and facial asymmetry / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to analyze the transverse dental compensation in reference to the maxillary and mandibular basal bones using cone-beam computed tomography (CBCT) and evaluate the correlations between transverse dental compensation and skeletal asymmetry variables in patients with skeletal Class III malocclusion and facial asymmetry. METHODS: Thirty patients with skeletal Class I (control group; 15 men, 15 women) and 30 patients with skeletal Class III with menton deviation (asymmetry group; 16 men, 14 women) were included. Skeletal and dental measurements were acquired from reconstructed CBCT images using OnDemand3D 1.0 software. All measurements were compared between groups and between the deviated and nondeviated sides of the asymmetry group. Correlation coefficients for the association between skeletal and dental measurements were calculated. RESULTS: Differences in the ramus inclination (p < 0.001), maxillary canine and first molar inclinations (p < 0.001), and distances from the canine and first molar cusp tips to the midmaxillary or midmandibular planes (p < 0.01) between the right and left sides were significantly greater in the asymmetry group than in the control group. In the asymmetry group, the ramus inclination difference (p < 0.05) and mandibular canting (p < 0.05) were correlated with the amount of menton deviation. In addition, dental measurements were positively correlated with the amount of menton deviation (p < 0.05). CONCLUSIONS: Transverse dental compensation was correlated with the maxillary and mandibular asymmetry patterns. These results would be helpful in understanding the pattern of transverse dental compensation and planning surgical procedure for patients with skeletal Class III malocclusion and facial asymmetry.

Three-dimensional study on symmetry of the first molar and its peripheric alveolar bone in skeletal class III patients with mandibular deviation / 上海交通大学学报（医学版）

Objective: To compare the difference of the first molar and alveolar morphology between the deviated side and non-deviated side in skeletal class III patients with mandibular deviation by using cone-beam computed tomography (CBCT) image combined with three-dimensional reconstruction measurement technology. Methods: Fifty-six asymmetric CBCT data were evaluated by Mimics 10.0 and 3-Matic software. Some measures were analyzed by t-test including the buccolingual angle, the mesiodistal angle, crown root ratio of first molar and the thickness of alveolar or cancellous bone. Results: The buccolingual angle and crown root ratio of mandibular first molar were significantly larger on the deviated side than on the non-deviated side (P=0.021, P=0.004). Compared with the non-deviated side, the buccal and total cancellous bone thickness of mandibular first molar were significantly smaller on the deviated side (P=0.043, P=0.048). There was no significant difference in the ratio of buccal and total cancellous bone thickness on mandibular first molar (both P=0.118). The measurements of maxillary first molar and maxillary alveolar bone morphology were not significantly different between two sides (all P>0.05). Conclusion: In skeletal class III patients with mandibular deviation, although the buccolingual compensation of first molar is found, the position of first molar in the alveolar bone is symmetrical. The asymmetry of alveolar bone morphology are mainly manifested in the reduction of the buccal and total cancellous bone thickness on the mandibular deviated side.

Opções de tratamento ortodôntico compensatório da classe III sem exodontias de premolares / Treatment options of compensatory orthodontic treatment without premolar extractions

O tratamento ortodôntico, em pacientes adultos com padrão esquelético apresentando pequena discrepância, pode ser realizado com a camuflagem ortodôntica, por meio das compensações dentárias. Essas compensações, muitas vezes, são consideradas como fatores de risco para a saúde periodontal, principalmente, quando associadas à movimentos de inclinação dos incisivos, tanto para lingual como para vestibular. A finalidade do presente artigo foi apresentar, através de dois de casos clínicos, duas opções diferentes de tratamento compensatório para a Classe III. A primeira com o emprego de bráquetes autoligáveis do Sistema Damon, com prescrição individualizada para os arcos dentários superior e inferior, além dos elásticos intermaxilares de Classe III. Essa modalidade tem sua indicação na correção dos problemas dentários com suave discrepância esquelética entre as bases ósseas, corrigindo os problemas oclusais sem grandes sequelas para os dentes e tecidos de suporte, devido ao torque diferenciado dos bráquetes. A segunda opção é a movimentação sagital dos dentes inferiores para distal por meio de ancoragem esquelética com miniplacas de titânio. Esses dispositivos de ancoragem temporária (DATs) oferecem uma estável e efetiva ancoragem para a movimentação ortodôntica no tratamento da Classe III.(AU)

Orthodontic treatment, in adult patients with a skeletal pattern presenting a small discrepancy, can be performed with orthodontic camouflage by dental compensations. These compensations are many times considered as risk factors for periodontal health, especially when associated with incisor inclination, both lingual and buccal. The aim of this paper was to present, through two clinical cases, two different options for compensatory Class III treatment. The first one with the use of self-ligating brackets (Damon System), with individualized prescriptions for upper and lower dental arches, in addition to Class III intermaxillary elastics. This modality has its indication in the correction of dental problems with mild skeletal discrepancy between bone bases, correcting the occlusal problems without major sequelae for teeth and supporting tissues, due to brackets different torque. The second option is retracting the whole lower dentition through skeletal anchorage with titanium miniplates. These temporary anchoring devices (TADs) provide a stable and effective anchorage for orthodontic movement in Class III treatment.(AU)

Study on Airway Size in Class III Malocclusion by the Gender / 체질인류학회지

The purpose of this study was to investigate the difference of airway between skeletal Class III malocclusion according to gender and to analyze the relationship between airway size and oral maxillofacial position. The total of 40 study subjects was sampled by judgment sampling, who were under 1 degree ANB and who wanted orthognathic surgery. They were taken with lateral cephalometric radiograph and the photos were used for final analysis. The variables were calculated using mean and standard deviation, those were analyzed by independent t-test, Pearson's correlation coefficient and multiple regression analysis. It was located forward than the female that was the measurements of frontal bone, maxilla, mandible, and mentum in the male. The laryngeal pharynx size of the hard and soft tissues was also longer than the female. It was not statistically significant that was the correlation between the variables and the oral pharynx size. However, the width of the laryngeal pharynx increased with male and mandibular protrusion, and it was increased with the position of the anterior of frontal bone, maxilla, and mentum. The variables affecting the airway size are the laryngeal pharynx width of the hard and soft tissue.

Evaluation of stability after pre-orthodontic orthognathic surgery using cone-beam computed tomography: A comparison with conventional treatment / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). METHODS: This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12). CBCT images acquired preoperatively, 1 month after surgery, and 1 year after surgery were analyzed to compare the intergroup differences in postoperative three-dimensional movements of the maxillary and mandibular landmarks and the changes in lateral cephalometric variables. RESULTS: Baseline demographics (sex and age) were similar between the two groups (6 men and 6 women in each group). During the postsurgical period, the POGS group showed more significant upward movement of the mandible (p < 0.05) than did the CS group. Neither group showed significant transverse movement of any of the skeletal landmarks. Moreover, none of the dental and skeletal variables showed significant intergroup differences 1 year after surgery. CONCLUSIONS: Compared with CS, POGS with IVRO resulted in significantly different postsurgical skeletal movement in the mandible. Although both groups showed similar skeletal and dental outcomes at 1 year after surgery, upward movement of the mandible during the postsurgical period should be considered to ensure a more reliable outcome after POGS.

The long term stability of skeletal class III malocclusion after orthodontic-surgery:A meta-analysis / 实用口腔医学杂志

Objective:To analyze the long term stability of the hard and soft tissues of the skeletal class III malocclusion after ortho-dontic-surgery by Meta-analysis.Methods:The randomized controlled trials(RCT),quasi-randomized controlled trials and clinical case-control trials(CCT)about the long-term stability of skeletal class III malocclusion after orthodontic-surgery was collected from Co-chrane Library,PubMed,Medline,CNKI,VIP and Wanfang databases from inception to December 31,2013 by literature search.Two professionally trained reviewers evaluated the quality of the screened literatures,scored literatures with the NOS evaluation tool,and collectd data and information of the literatures with medium and higher quality.Revman5.2 was used for the Meta-analysis.Results:4 CCTs articles and 178 cases were included.The results of Meta-analysis showed that:1.The stability of the hard tissue:the differ-ence of SNA(WMD =-0.58,95%CI[-1.18,0.02]),SNB (WMD =0.25,95%CI[-0.42,0.91]),ANB(WMD =-0.70, 95%CI[-1.44,0.04])and MP-SN(WMD =0.39,95%CI[-0.25,1.04])at post-operation and 3 years after operation had no statistical significance.Point A remained relatively stable position and point B had some replace 3 years after surgery compared with that at post-operative.2.The stability analysis of soft tissue:the healing effect of the soft tissue was stable,except the LowerlipeNperp had some recurrence 3 years after surgery.Conclusion:In the long term,after orthodontic and surgical treatment for skeletal class III malocclusion the hard and soft tissues kept stabile except a little replapse of the mandibular and the LowerlipeNperp.

The Vertical Changes of Lip and Perioral Soft Tissue Following Orthognathic Surgery in Skeletal Class III Patients by a Cephalometric Analysis of Cone Beam Computed Tomography

THE SKELETAL STABILITY OF LE FORT I MAXILLARY ADVANCEMENT