Cephalometric changes after the correction of class III malocclusion with maxillary expansion/facemask therapy.

The purpose of this study was to analyze the cephalometric changes that occurred during and after the correction of Class III malocclusion. The records of 24 Class III patients treated with a banded expansion appliance and custom facemask were compared with 24 Class I and 27 Class III untreated controls. Cephalometric means were calculated for the annualized data and compared univariately with unpaired t tests to determine significant differences. Treatment results showed more convexity of the facial profile from anterior displacement and downward and backward rotation of the maxilla and clockwise rotation of the mandible. The maxillary teeth moved forward while the lower incisors retruded. Postprotraction results showed the maxilla did not relapse after treatment but grew anteriorly similar to the Class III controls but less than the Class I controls. Mandibular growth was similar for the treatment and control groups. Dental changes compensated for decreasing overjet whereas the soft tissue profile showed no significant posttreatment changes. Results in the intercontrol comparison showed the Class III controls had significantly less forward movement of A-point and greater forward movement of the mandible than Class I controls. Because of these differences using a Class I control group to compare to a Class III treatment group will tend to underestimate the treatment effects and overestimate posttreatment changes. Overcorrection of the Class III malocclusion is recommended to compensate for postprotraction growth deficiency of the maxilla.

Cephalometric effects of face mask/expansion therapy in Class III children: a comparison of three age groups.

The purpose of this investigation was to determine the skeletal, dental, and soft tissue effects of face mask/expansion therapy and to examine the effect of age on treatment response. Pretreatment and posttreatment cephalometric radiographs from 63 subjects (4 to 13 years) who had a Class III malocclusion were analyzed. Serial cephalometric tracings of 32 subjects with Class I occlusion made at 4, 6, 8, 10, 12, and 14 years were used as controls. Landmarks were digitized on each tracing and treatment effects were measured by using cranial base and maxillary superimposition techniques. Annual rate differences were compared with t tests for the combined treated group (N = 63) and between stratified treated groups (4 to 7 years N = 15, 7 to 10 years N = 32, 10 to 14 years N = 16). The treated group (N = 63) demonstrated significant (p < 0.001) hard and soft tissue changes that resulted from treatment. Skeletal change was primarily a result of anterior and vertical movement of the maxillae. Mandibular position was directed in a downward and backward vector. Orthodontic changes contributed to the correction, and soft tissue effects resulted in a more convex profile. Minimal significant differences were observed between age groups when comparing angular and linear measurements alone. However, when analyzing the algebraic sum of treatment effects (Johnston analysis), significantly (p < 0.01) greater differences were observed in apical base change (ABCH) and total molar correction (6/6) in the younger age groups. This study demonstrates that face mask/expansion therapy produces dentofacial changes that combine to improve the Class III malocclusion. Although early treatment may be most effective, face mask therapy can provide a viable option for older children as well.