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Rutili V, Souki BQ, Nieri M, Carlos ALFM, Pavoni C, Cozza P, McNamara JA, Giuntini V, Franchi L. Long-term effects produced by early treatment of Class III malocclusion with rapid maxillary expansion and facemask followed by fixed appliances: A multicentre retro-prospective controlled study. Orthod Craniofac Res 2024; 27:429-438. [PMID: 38146808 DOI: 10.1111/ocr.12748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/11/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To assess the short- and long-term dentoskeletal effects of early Class III treatment with rapid maxillary expansion and facemask (RME/FM) followed by fixed appliances. MATERIALS AND METHODS A total of 44 patients (27 females, 17 males) treated consecutively with RME/FM were included from the archives of 3 centres. Three lateral cephalograms were available: T0 (before the start of RME/FM therapy, mean age 8.1 ± 1.8 years), T1 (immediately after RME/FM, mean age 9.8 ± 1.6 years), and T2 (long-term observation, mean age 19.5 ± 1.6 years). A control group of 17 untreated Class III subjects (12 females and 5 males) also was selected. Between-group statistical comparisons were performed with ANCOVA. RESULTS No statistically significant differences for any of the cephalometric variables were found at T0. In the short term, the treated group showed significant improvements in ANB (+2.9°), Wits appraisal (+2.7 mm), SNA (+1.8°) and SNB (-1.1°). A significant closure of CoGoMe angle (-1.3°) associated with smaller increments along Co-Gn (-2.4 mm) also was found together with a significant increase in intermaxillary divergence (+1.3°). In the long-term, significant improvements in ANB (+2.6°), Wits appraisal (+2.7 mm) and SNB (-1.7°) were recorded together with a significant closure of the CoGoMe angle (-2.9°). No significant long-term changes in vertical skeletal relationships were found. CONCLUSIONS RME/FM therapy was effective in improving Class III dentoskeletal relationships in the short term. These changes remained stable in the long-term due mainly to favourable mandibular changes.
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Affiliation(s)
- Valentina Rutili
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | | | - Chiara Pavoni
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - Paola Cozza
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, Michigan, USA
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
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Li Z, Hung KF, Ai QYH, Gu M, Su YX, Shan Z. Radiographic Imaging for the Diagnosis and Treatment of Patients with Skeletal Class III Malocclusion. Diagnostics (Basel) 2024; 14:544. [PMID: 38473016 DOI: 10.3390/diagnostics14050544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
Skeletal Class III malocclusion is one type of dentofacial deformity that significantly affects patients' facial aesthetics and oral health. The orthodontic treatment of skeletal Class III malocclusion presents challenges due to uncertainties surrounding mandibular growth patterns and treatment outcomes. In recent years, disease-specific radiographic features have garnered interest from researchers in various fields including orthodontics, for their exceptional performance in enhancing diagnostic precision and treatment effect predictability. The aim of this narrative review is to provide an overview of the valuable radiographic features in the diagnosis and management of skeletal Class III malocclusion. Based on the existing literature, a series of analyses on lateral cephalograms have been concluded to identify the significant variables related to facial type classification, growth prediction, and decision-making for tooth extractions and orthognathic surgery in patients with skeletal Class III malocclusion. Furthermore, we summarize the parameters regarding the inter-maxillary relationship, as well as different anatomical structures including the maxilla, mandible, craniofacial base, and soft tissues from conventional and machine learning statistical models. Several distinct radiographic features for Class III malocclusion have also been preliminarily observed using cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI).
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Affiliation(s)
- Zhuoying Li
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kuo Feng Hung
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Qi Yong H Ai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Min Gu
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Zhiyi Shan
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Rutili V, Quiroga Souki B, Nieri M, Farnese Morais Carlos AL, Pavoni C, Cozza P, McNamara JA, Giuntini V, Franchi L. Long-Term Assessment of Treatment Timing for Rapid Maxillary Expansion and Facemask Therapy Followed by Fixed Appliances: A Multicenter Retro-Prospective Study. J Clin Med 2023; 12:6930. [PMID: 37959395 PMCID: PMC10649687 DOI: 10.3390/jcm12216930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/15/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND to determine the role of treatment timing in the long-term effects produced by rapid maxillary expansion and facemask therapy (RME/FM) in Class III patients. METHODS This study compared two sample groups treated with RME/FM followed by fixed appliances: the early prepubertal group (EPG) (17 patients; mean age before treatment (T0), 5.8 ± 0.7 years; range, 4.3-6.9 years) and the late prepubertal group (LPG) (17 patients; mean age at T0, 10.1 ± 0.8 years; range, 9.0-11.1 years). Lateral cephalograms for the two groups were examined before treatment (T0) and at a long-term observation (T1) (EPG, 19.8 ± 1.0 years; LPG, 21.0 ± 2.1 years). Independent sample t-tests were performed to compare the two groups at T0 and T1. RESULTS No statistically significant differences were found for any of the cephalometric variables at T0, except for the total mandibular length, overjet, and inclination of the maxillary incisors to the palatal plane, which were greater in the LPG. At T1, no statistically significant differences were detected for any of the cephalometric variables. CONCLUSIONS There were no significant long-term differences when treating Class III patients with RME/FM, either during an early prepubertal phase (≤7 years of age) or during a late prepubertal phase (≥9 years of age).
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Affiliation(s)
- Valentina Rutili
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte 30535-610, Brazil; (B.Q.S.); (A.L.F.M.C.)
| | - Michele Nieri
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Ana Luiza Farnese Morais Carlos
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte 30535-610, Brazil; (B.Q.S.); (A.L.F.M.C.)
| | - Chiara Pavoni
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, 00131 Rome, Italy; (C.P.); (P.C.)
| | - Paola Cozza
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, 00131 Rome, Italy; (C.P.); (P.C.)
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI 48109, USA;
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
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Lee MS, Le VNT, Kim JG, Yang YM, Lee DW. Prediction Model for Future Success of Early Orthopedic Treatment of Class III Malocclusion. Children (Basel) 2023; 10:children10020355. [PMID: 36832484 PMCID: PMC9955582 DOI: 10.3390/children10020355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
This study aimed to identify predictors for successful post-treatment outcomes in early orthopedic class III malocclusion treatment with a facemask and hyrax expander appliance. The study was performed on lateral cephalograms from 37 patients at the start of treatment (T0), post-treatment (T1), and a minimum of three years after treatment (T2). The patients were grouped as stable or unstable according to the existence of a 2-mm overjet at T2. For statistical analysis, independent t-tests were used to compare the baseline characteristics and measurements of the two groups, considering a significance level of < 0.05. Thirty variables of pretreatment cephalograms were considered during logistic regression analysis to identify predictors. A discriminant equation was established using a stepwise method. The success rate and area under the curve were calculated, with AB to the mandibular plane, ANB, ODI, APDI, and A-B plane angles as predictors. The A-B plane angle was the most significantly different between the stable and unstable groups. In terms of the A-B plane angle, the success rate of early class III treatment with a facemask and hyrax expander appliance was 70.3%, and the area under the curve indicated a fair grade.
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Affiliation(s)
- Mi-So Lee
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju 54896, Republic of Korea
- Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Van Nhat Thang Le
- Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, Hue University, Hue 49120, Vietnam
| | - Jae-Gon Kim
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju 54896, Republic of Korea
- Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Yeon-Mi Yang
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju 54896, Republic of Korea
- Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Dae-Woo Lee
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju 54896, Republic of Korea
- Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
- Correspondence: ; Tel.: +82-63-250-2826
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Papadopoulou AK, Koletsi D, Masucci C, Giuntini V, Franchi L, Darendeliler MA. A retrospective long-term comparison of early RME-facemask versus late Hybrid-Hyrax, alt-RAMEC and miniscrew-supported intraoral elastics in growing Class III patients. Int Orthod 2021;:100603. [PMID: 34972642 DOI: 10.1016/j.ortho.2021.100603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare the long-term dentoskeletal effects of early treatment with banded or bonded RME (Rapid Maxillary Expansion)-Face Mask (RME-FM) versus late treatment with bonded Hybrid-Hyrax, alt-RAMEC (Alternate Rapid Maxillary Expansion and Contraction) and intraoral Class III elastics anchored to miniscrew-reinforced-Lower-lingual-Arch (alt-RAMEC-HH-LLA) in growing, maxillary retrognathic patients. MATERIALS AND METHODS Two groups were matched at long-term follow-up retrospectively. Patients received either early RME-FM (n=16, 5 males, 11 females, age T1: 6.5±0.9 years, age T2: 15.8±2.5 years) or late alt-RAMEC-HH-LLA (n=15, 7 males, 8 females, age T1: 12.52±0.94 years, age T2: 16.8±0.9 years). Total follow-up was 9.2±2.3 years and 4.2±0.2 years respectively, including fixed appliances to compete treatment. RESULTS Both treatments resulted in Class III correction except one unsuccessful case of alt-RAMEC-HH-LLA. Active maxillary protraction was 1.6±0.5years with RME-FM and 0.5 years with alt-RAMEC-HH-LLA being significantly shorter (P<0.001). Values at T2 estimation with multivariate linear regression for correlated multiple outcomes, conditional on baseline estimates, age and sex showed alt-RAMEC-HH-LLA inducing significantly more retroclined lower incisors (mean: -6.11°; 95%CI: -10.66, -1.57; P=0.01), less overbite (mean: -1.28mm; 95%CI: -1.79, -0.761; P<0.001), less maxillo (Co-A)- (mean: -4.54mm; 95%CI: -7.91, -1.16; P=0.01) mandibular (Co-Gn) (mean: -10.5mm; 95%CI: -17.45, -3.55; P=0.003) projections/size, more open gonial angle (mean: 4.93°; 95%CI: 2.27, 7.59; P<0.001), and less S-N length (mean: -5.04mm; 95%CI: -6.57, -3.51; P<0.001). CONCLUSIONS Patients treated with either early RME-FM or late Alt-RAMEC-HH-LLA had comparable overall post-pubertal skeletal and overjet corrections. However, the late Alt-RAMEC-HH-LLA showed less correction of dentoalveolar compensations and in particular of the mandibular incisors. The overbite, maxillary and mandibular projection and size were lower and the gonial angle was more open.
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Paoloni V, De Razza FC, Franchi L, Cozza P. Stability prediction of early orthopedic treatment in Class III malocclusion: morphologic discriminant analysis. Prog Orthod 2021; 22:34. [PMID: 34541628 DOI: 10.1186/s40510-021-00379-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/31/2021] [Indexed: 11/16/2022] Open
Abstract
Background To evaluate morphologic differences between class III malocclusion success and failure treatment subjects in order to identify which variables are more predictive for long-term stability in early orthopedic treatment. In this retrospective study, 31 patients were enrolled from the Department of Orthodontics (Rome Tor Vergata). Inclusion criteria were as follows: white ancestry, class III malocclusion, mixed dentition, cervical stage (CS) 1-2, no pseudo-class III. Pre-treatment radiographic and cast records were collected. Each patient underwent rapid maxillary expansion/facial mask/bite block (RME/FM/BB) orthopedic treatment until correction. At T1 (permanent dentition, CS4), records were recollected. According to treatment stability, relapse group (RG, 19) and success group (SG, 12) were identified. Sagittal and vertical cephalometric and digital cast measurements were performed. Student’s t tests were used for statistically significant differences inter and intra groups. For discriminant analysis, relapse or success status was added to each patient’s T0 data. Results At T0, RG showed larger upper anterior transversal width (p = 0.0266), while at T1 the upper anterior length was shorter than SG (p = 0.0028). Between T1 and T0, both groups showed larger upper anterior and posterior transversal widths. SG had greater upper anterior (p = 0.0066) and posterior (p = 0.449) sagittal length. RG presented larger lower anterior (p = 0.0012) and posterior (p = 0.0002) transversal widths, while there were no differences in SG lower arch. Discriminant analysis provided two predictive variables with an accuracy of 80.6%: upper anterior length and upper posterior length. Conclusion A shorter and wider maxilla could be a predisposing factor for relapse and failure of the early orthopedic treatment of class III malocclusion patients. The absence of mandibular changes could be predictable for treatment success.
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Montinaro F, Nucci L, Carfora M, d'Apuzzo F, Franchi L, Perillo L. Modified SEC III protocol: vertical control related to patients' compliance with the chincup. Eur J Orthod 2021; 43:80-85. [PMID: 32346723 DOI: 10.1093/ejo/cjaa030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To compare the short-term outcomes of modified SEC III protocol in growing patients in relation to their compliance with the chincup, matching them with an untreated Class III control group (CG). MATERIALS AND METHODS Thirty-four patients (mean age of 8.6 ± 1.2 years) with Class III dentoskeletal malocclusion treated with the modified SEC III protocol and divided into group 1 (G1, 18 subjects), reporting good compliance and group 2 (G2, 16 subjects) not compliant with the chincup. The records were analysed before treatment (T1) and after the orthopaedic phase (T2), with an interval period of about 1.3 ± 0.5 years. The CG consisted of 16 untreated subjects with Class III dentoskeletal malocclusion (mean age of 8.3 ± 1.4 years). The statistical comparisons among the three groups were performed with ANOVA with Tukey's post hoc tests. RESULTS Both G1 and G2, compared with CG, presented significant improvements in the sagittal skeletal relationships (ANB +2.5° and +2.5°, Wits +4.2° and +3.0°, respectively). G1 exhibited a significant more favourable control of vertical skeletal relationships when compared to G2 (Palatal Pl.-Mandibular Pl. -2.0°) that were associated with a statistically significant reduction of the gonial angle (ArGoMe -1.7°). Limitations of the study were its retrospective nature and the lack of evaluation of the long-term outcomes. CONCLUSIONS Both groups of treated patients showed favourable sagittal skeletal improvement compared with controls. The use of chincup in patients with good compliance produced significantly greater control of the skeletal vertical dimensions compared with patients not compliant with the chincup.
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Affiliation(s)
- Federica Montinaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marco Carfora
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fabrizia d'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Kakali L, Christopoulou I, Tsolakis IA, Sabaziotis D, Alexiou A, Sanoudos M, Tsolakis AI. Mid-term follow up effectiveness of facemask treatment in class III malocclusion: A systematic review. Int Orthod 2021; 19:365-376. [PMID: 34305011 DOI: 10.1016/j.ortho.2021.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This systematic review aims to investigate and summarize the mid-term effects and stability of the treatment with facemask appliance. METHODS Search without restrictions in five databases (Pubmed, Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials) since inception and hand searching until March 2021 was conducted. Detailed search strategies were based on the PubMed strategy and adapted accordingly. Studies assessing the mid-term effects of facemask appliance, with a follow-up post-treatment period of more than 6 years or after the peak of pubertal growth, were to be included. The risk of bias in individual studies was assessed using the Cochrane guidelines for the RCT and the ROBINS-I tool for the non-RCT studies. RESULTS Five studies were finally considered eligible for inclusion (one RCT and four CCTs). According to the reported evidence, the mid-term success rate ranged from 62.7% to 100%. Mid-term success was identified with positive overjet as well as acceptable aesthetic and functional characteristics. CONCLUSIONS Class III malocclusion treated with facemask presents a high percentage of success in the mid-term follow-up period. The mid-term effects of facemask were stable for the maxilla, in terms of sagittal and anteroposterior dentoskeletal dimensions, and any kind of relapse is attributed to uncontainable residual growth of the mandible. However, considering the high risk of bias and the follow-up period limitations, more high-quality studies are necessary in order to achieve further clarification. Future research should be based also on identifying biomarkers to indicate likely treatment responses. REGISTRATION NUMBER PROSPERO: CRD42020179402.
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Affiliation(s)
- Lydia Kakali
- University of Athens, School of Dentistry, Department of Orthodontics, Athens, Greece
| | - Isidora Christopoulou
- University of Athens, School of Dentistry, Department of Orthodontics, Athens, Greece.
| | - Ioannis A Tsolakis
- University of Athens, School of Dentistry, Department of Orthodontics, Athens, Greece
| | - Dimitris Sabaziotis
- University of Athens, School of Dentistry, Department of Orthodontics, Athens, Greece
| | - Antigoni Alexiou
- University of Athens, School of Dentistry, Department of Orthodontics, Athens, Greece
| | - Mattheos Sanoudos
- University of Athens, School of Dentistry, Department of Orthodontics, Athens, Greece
| | - Apostolos I Tsolakis
- University of Athens, School of Dentistry, Department of Orthodontics, Athens, Greece; Case Western Reserve University, School of Dental Medicine, Department of Orthodontics, Cleveland, OH, USA
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Fabozzi FF, Nucci L, Correra A, d'Apuzzo F, Franchi L, Perillo L. Comparison of two protocols for early treatment of dentoskeletal Class III malocclusion: Modified SEC III versus RME/FM. Orthod Craniofac Res 2020; 24:344-350. [PMID: 33179446 DOI: 10.1111/ocr.12440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/20/2020] [Accepted: 11/01/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare the short-term cephalometric outcomes of the protocols modified splints, Class III elastics, chincup (SEC III) and rapid maxillary expansion and facial mask (RME/FM) for the early treatment of growing subjects with Class III dentoskeletal malocclusion. SETTINGS AND SAMPLE POPULATION This retrospective observational study included 20 patients (11 males, nine females) treated with the modified SEC III protocol and 31 patients (16 males, 15 females) treated with the RME/FM one. The sample was evaluated before (T1, mean age 7.9 ± 1.0 years) and at the end of treatment (T2, mean age 9.0 ± 1.0 years). Statistical comparisons between the two groups were performed with independent sample t tests. RESULTS Both the modified SEC III and the RME/FM sample groups showed significantly favourable effects in terms of maxillary advancement (SNA +1.3° and +1.5°, respectively), control of mandibular projection (SNB -0.5° and -0.8°, respectively), and intermaxillary relationships (ANB +1.8° and +2.3°, respectively; Wits +3.4 and +1.9 mm, respectively). The modified SEC III group showed a statistically significant greater control in the intermaxillary divergency considering the SN to Pal. Pl. (P < 0.006) and Pal. Pl. to Mand. Pl. angle (P < 0.002) with a difference of 2.3 mm between the two groups. LIMITATIONS The main limitations of this study are its retrospective nature and the short-term outcomes. CONCLUSION Early treatment of growing patients with dentoskeletal Class III disharmonies is efficient using either modified SEC III or RME/FM protocols. However, a higher vertical control is achieved with the modified SEC III.
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Affiliation(s)
- Filomena Federica Fabozzi
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonia Correra
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fabrizia d'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Cha BK, Park JH, Choi DS, Jang I. Facemask therapy with skeletal anchorage: A possible alternative to orthognathic surgery. Orthod Craniofac Res 2020; 24 Suppl 1:13-20. [PMID: 33119188 DOI: 10.1111/ocr.12436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 11/30/2022]
Abstract
Treatment of skeletal Class III malocclusion in young patients is very challenging. Facemask therapy has been proven to be effective in early correction of Class III malocclusion. With the aid of skeletal anchorage, the orthopaedic effects are expected to be greater than the effects with conventional facemask with tooth-borne anchorage. However, only a few studies have reported on the long-term stability of facemask therapy combined with skeletal anchorage. This report examines two patients with skeletal Class III malocclusion who were treated with facemask and skeletal anchorage followed by orthodontic treatment using fixed orthodontic appliances. The long-term effects of facemask therapy with skeletal anchorage are discussed and compared with the conventional facemask therapy.
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Affiliation(s)
- Bong-Kuen Cha
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Dong-Soon Choi
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea
| | - Insan Jang
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea
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de Frutos-Valle L, Martin C, Alarcón JA, Palma-Fernández JC, Ortega R, Iglesias-Linares A. Sub-clustering in skeletal class III malocclusion phenotypes via principal component analysis in a southern European population. Sci Rep 2020; 10:17882. [PMID: 33087764 PMCID: PMC7578100 DOI: 10.1038/s41598-020-74488-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 09/28/2020] [Indexed: 02/08/2023] Open
Abstract
The main aim of this study was to generate an adequate sub-phenotypic clustering model of class III skeletal malocclusion in an adult population of southern European origin. The study design was conducted in two phases, a preliminary cross-sectional study and a subsequent discriminatory evaluation by main component and cluster analysis to identify differentiated skeletal sub-groups with differentiated phenotypic characteristics. Radiometric data from 699 adult patients of southern European origin were analyzed in 212 selected subjects affected by class III skeletal malocclusion. The varimax rotation was used with Kaiser normalization, to prevent variables with more explanatory capacity from affecting the rotation. A total of 21,624 radiographic measurements were obtained as part of the cluster model generation, using a total set of 55 skeletal variables for the subsequent analysis of the major component and cluster analyses. Ten main axes were generated representing 92.7% of the total variation. Three main components represented 58.5%, with particular sagittal and vertical variables acting as major descriptors. Post hoc phenotypic clustering retrieved six clusters: C1:9.9%, C2:18.9%, C3:33%, C4:3.77%, C5:16%, and C6:16%. In conclusion, phenotypic variation was found in the southern European skeletal class III population, demonstrating the existence of phenotypic variations between identified clusters in different ethnic groups.
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Affiliation(s)
- L de Frutos-Valle
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain
| | - C Martin
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain.,Craniofacial Biology Research Group, BIOCRAN, Complutense University, Plaza Ramón y Cajal, s/n, 28040, Madrid, Spain
| | - J A Alarcón
- Section of Orthodontics, Faculty of Odontology, University of Granada, Campus Universitario de Cartuja, Granada, Spain
| | - J C Palma-Fernández
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain
| | - R Ortega
- Faculty of Odontology, Complutense University, Madrid, Spain
| | - A Iglesias-Linares
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain. .,Craniofacial Biology Research Group, BIOCRAN, Complutense University, Plaza Ramón y Cajal, s/n, 28040, Madrid, Spain.
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Pellegrino M, Caruso S, Cantile T, Pellegrino G, Ferrazzano GF. Early Treatment of Anterior Crossbite with Eruption Guidance Appliance: A Case Report. Int J Environ Res Public Health 2020; 17:E3587. [PMID: 32443794 PMCID: PMC7277547 DOI: 10.3390/ijerph17103587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 11/26/2022]
Abstract
The purpose of this investigation was to show how to manage an anterior crossbite in early mixed dentition with an eruption guidance appliance (EGA). The analyzed clinical case reported an anterior crossbite, a bimaxillary retrusion tendency, and a horizontal growth pattern. The anterior crossbite was an unfavorable occlusal condition that could lead to a class III malocclusion growth pattern. An early treatment approach was suggested to reach a correct sagittal jaw relationship. Hence, the selected approach acted on the dentoalveolar sector, aiming to have effects on the posterior vertical dimension and to improve the sagittal jaw's relation. An EGA was selected to treat the patient in early mixed dentition. After 7 months of therapy with night-time use, the dental malocclusion was completely resolved. The patient continued to be treated with the same device, used as active retention. With the EGA treatment, the erupting forces, rather than the active forces, were used to resolve the dental malocclusion. This approach allowed a low compliance requirement and had a minimum psychosocial and psychological impact on the patient. The early treatment was essential to give a functional occlusion and a good balance of the soft perioral tissues and muscles.
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Affiliation(s)
| | - Silvia Caruso
- Department of Health, Life and Environmental Science, University of L’Aquila, 67100 L’Aquila, Italy; (S.C.); (G.P.)
| | - Tiziana Cantile
- Department of Neuroscience, Reproductive and Oral Sciences, School of Paediatric Dentistry, University of Naples, Federico II, 80138 Naples, Italy; (T.C.); (G.F.F.)
| | - Gioacchino Pellegrino
- Department of Health, Life and Environmental Science, University of L’Aquila, 67100 L’Aquila, Italy; (S.C.); (G.P.)
| | - Gianmaria Fabrizio Ferrazzano
- Department of Neuroscience, Reproductive and Oral Sciences, School of Paediatric Dentistry, University of Naples, Federico II, 80138 Naples, Italy; (T.C.); (G.F.F.)
- UNESCO Chair in Health Education and Sustainable Development: Oral Health in Paediatric Age, University of Naples Federico II, 80138 Naples, Italy
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