Comparison of Gingival Recession of Mandibular Incisors of Class III Patients Immediately after Compensatory or Surgical Orthodontic Treatment.

OBJECTIVE: This study aimed to compare gingival recession in mandibular anterior teeth in patients with Class III malocclusion, immediately after compensatory or surgical orthodontic treatment. MATERIALS AND METHODS: The sample consisted of 40 patients with Class III malocclusion, divided into two groups: Group 1 (compensatory), 20 patients treated with compensatory orthodontics, with a mean initial age of 20.26 years (standard deviation [SD] . = 7.44), mean final age of 23.07 years (SD = 7.32), and mean treatment time of 2.81 years (SD =0.84). Group 2 (surgical), who undergone orthodontic-surgical treatment, with a mean initial age of 23.08 years (SD =5.48), mean final age of 25.43 years (SD =5.12), and mean treatment time of 2.35 years (SD =1.56). Intraoral photographs taken before and after removal of the fixed orthodontic appliance were used to measure the gingival recession, from the cervical of the mandibular incisors from the most cervical point of the gingival margin to the cementoenamel junction. In the initial and final cephalograms, the position of the mandibular incisors was measured. The intergroup comparison was performed using the independent t-test. RESULTS: The results showed that there was no statistically significant difference in the gingival recession at the beginning, at the end, and of changes with treatment between the compensatory and surgical groups. CONCLUSION: It was concluded that the compensatory and surgical orthodontic treatments for Class III malocclusion showed similar results regarding the gingival recession of the mandibular incisors.

Smile attractiveness in class III patients after orthodontic camouflage or orthognathic surgery.

OBJECTIVE: The study's objective was to compare the smile attractiveness in patients with class III malocclusion treated with orthodontic camouflage or orthognathic surgery. MATERIAL AND METHODS: The sample consisted of 30 patients with class III malocclusion treated without extractions divided into two groups, according to the treatment performed: G1, orthodontic camouflage, consisting of 15 patients (9 female; 6 male) with mean initial age of 21.26 years (SD = 7.39) and mean final age of 24.52 years (SD = 7.10). The mean treatment time was 3.26 years (SD = 1.50). G2, ortho-surgical, consisting of 15 patients (8 females; 7 males), with mean initial age of 23.12 years (SD=7.37), mean final age of 25.82 years (SD = 7.14) and mean treatment time of 2.71 years (SD = 0.90). The smile attractiveness was evaluated in black and white photographs of posed smiles taken before and after treatment, with a numerical rating scale from 1 to 10, with 1 being the least attractive and 10 the greatest smile attractiveness. The smiles were evaluated in a questionnaire by 111 participants, 67 orthodontists (mean age 41.31 years, SD = 9.44) and 44 laypeople (mean age 41.41 years, SD = 14.38). Intergroup comparison was performed with independent t test. RESULTS: There was a significant improvement in the smile attractiveness with both camouflage and ortho-surgical treatments. The smile attractiveness was similar between the camouflage and surgical groups at the beginning. There was a significantly greater improvement in smile attractiveness with treatment in the surgical group than in the camouflage group, and at the end of treatment, the surgical group showed greater smile attractiveness than the camouflage group. Orthodontists considered the smiles more attractive both at the beginning and the end of treatment when compared to the assessment made by laypeople. CONCLUSION: The ortho-surgical treatment promoted a greater improvement in the smile attractiveness, and at the final stage, a greater smile attractiveness than the orthodontic camouflage. CLINICAL RELEVANCE: Smile attractiveness is an important characteristic of the final result of orthodontic treatment. Knowing which treatment protocol will provide a better improvement and outcome regarding smile esthetics is essential.

Comparison of the facial profile attractiveness in Class III borderline patients after surgical or compensatory orthodontic treatment.

BACKGROUND: This study aimed to compare the facial profile attractiveness of Class III borderline patients after surgical or compensatory orthodontic treatment. MATERIAL AND METHODS: The sample consisted of 60 borderline Class III malocclusion patients, divided into two groups: Group 1 (Surgical): 30 patients (16 male; 14 female) treated with orthodontic fixed appliances and bimaxillary orthognathic surgery. Mean initial age was 20.05 years (s.d.=2.40) and mean treatment time was 2.23 years (s.d.=0.82). Group 2 (Compensatory): 30 patients (13 male; 17 female) treated compensatorily with fixed appliances and Class III elastics. Mean initial age was 18.53 years (s.d.=4.35) and mean treatment time was 2.08 years (s.d.=0.67). Silhouettes of the facial profile were constructed obtained from the pretreatment and posttreatment lateral cephalograms and evaluated by orthodontists (N=41, 22 females and 19 males, mean age of 35.65 years), assigning scores from 1 (least attractive) to 10 (most attractive). Intergroup comparison of profile attractiveness was performed by Mann-Whitney test. For intragroup comparison of initial and final stages, the Wilcoxon test was used. RESULTS: At initial stage, the compensatory group presented a statistically significant greater attractiveness of the profile than the surgical group. With treatment, the surgical group presented significantly more improvement in facial profile than the compensatory group. At the final stage, profile attractiveness of surgical and compensatory groups was similar. CONCLUSIONS: The facial profile attractiveness is similar in Class III patients after orthognathic surgery or compensatory orthodontic treatment. However, surgery provided more improvement in profile attractiveness than the compensatory treatment in Class III patients. Key words:Malocclusion, angle Class III, orthognathic surgery, corrective orthodontics.

Relapse of anterior crowding 3 and 33 years postretention.

INTRODUCTION: The aim of this study was to evaluate the relapse of occlusal characteristics and maxillary and mandibular anterior crowding 3 and 33 years postretention. METHODS: The sample comprised 28 patients, 15 Class I and 13 Class II, treated with 4 premolar extractions, with a mean initial age of 12.72 years (SD, 0.99), a mean final age of 14.74 years (SD, 1.26), and a mean treatment time of 2.02 years (SD, 0.66). The mean short-term postretention age was 20.15 years (SD, 1.34), and the mean long-term postretention age was 49.40 years (SD, 4.54). The mean time of short-term postretention evaluation was 3.70 years (SD, 0.87) and the mean long-term postretention evaluation was 32.95 years (SD, 4.31). The maxillary and mandibular irregularity indexes were assessed on the initial, final, short-term, and long-term postretention stage dental casts. Peer Assessment Rating and the Little indexes were compared among the 4 stages by repeated measures analysis of variance and Tukey tests. RESULTS: Peer Assessment Rating index and maxillary anterior crowding were significantly improved with treatment, had significant relapses in the short term, and a slight and not statistically significant increase from short-term to long-term postretention evaluation. The mandibular irregularity index significantly decreased with treatment, and then significantly and progressively increased in the postretention stages. CONCLUSIONS: The occlusal characteristics and maxillary anterior crowding had significant relapses in the short term and remained stable from the short-term to the long-term postretention stages. Mandibular anterior crowding significantly decreased with treatment, showed a significant relapse in the short term, and continued to significantly increase in the long-term postretention stage.

Class III Malocclusion Surgical-Orthodontic Treatment.

The aim of the present case report is to describe the orthodontic-surgical treatment of a 17-year-and-9-month-old female patient with a Class III malocclusion, poor facial esthetics, and mandibular and chin protrusion. She had significant anteroposterior and transverse discrepancies, a concave profile, and strained lip closure. Intraorally, she had a negative overjet of 5 mm and an overbite of 5 mm. The treatment objectives were to correct the malocclusion, and facial esthetic and also return the correct function. The surgical procedures included a Le Fort I osteotomy for expansion, advancement, impaction, and rotation of the maxilla to correct the occlusal plane inclination. There was 2 mm of impaction of the anterior portion of the maxilla and 5 mm of extrusion in the posterior region. A bilateral sagittal split osteotomy was performed in order to allow counterclockwise rotation of the mandible and anterior projection of the chin, accompanying the maxillary occlusal plane. Rigid internal fixation was used without any intermaxillary fixation. It was concluded that these procedures were very effective in producing a pleasing facial esthetic result, showing stability 7 years posttreatment.

Nasolabial angle at rest and upon smiling.

PURPOSE: The objectives of this study were 1) to determine the mean and SD of the nasolabial angle (NLA) and the linear measure pronasale (Prn)-A' at rest and upon smiling and 2) to determine the difference between smile and rest in participants with normal occlusion and facial harmony. MATERIALS AND METHODS: The sample consisted of 40 white Brazilian participants (20 of each gender) aged 20 to 30 years and with normal occlusion, a pleasant profile, and facial harmony. The measures NLA and Prn-A' were analyzed in profile photographs at rest and during smile, with a millimeter ruler in front of the profile during use of the Dolphin software. The statistical analysis included dependent t tests to compare the rest and smiling variables. RESULTS: The mean of the NLA at rest was 104.93°; it was 110.67° during smile; and the difference between them was statistically significant, with a mean of 5.74°. The mean of the linear variable Prn-A' at rest was 23.25 mm, whereas during smile it was 24.04 mm, and the difference between them was statistically significant, with a mean of 0.79 mm. CONCLUSIONS: The variability in the NLA and Prn-A' at rest and upon smiling was found to be significant in a normal sample, and it should be considered as a diagnostic tool in the treatment planning for sagittal dentoskeletal deformities.