Early Timely Treatment of Class III Malocclusion

The protraction facemask has been widely used in the treatment of Class III malocclusion with maxillary deficiencies. However, the benefit of this early treatment modality is not clear. One of the reasons orthodontists are reluctant to render early orthopedic treatment in Class III patients is the inability to predict mandibular growth. The use of a single cephalometric radiograph to predict excessive mandibular growth has severe limitations. The use of serial cephalometric radiographs taken a few years after facemask treatment, and a Growth Treatment Response Vector (GTRV) analysis to individualize and enhance the accuracy in predicting excessive mandibular growth, is presented and proposed. This article discusses the rationale for early "timely" treatment of Class III malocclusion, the indications and contraindications for early Class III treatment, and provides a method of predicting excessive mandibular growth using the GTRV analysis.

[1]  Ian D. Shaw,et al.  Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 2: Psychosocial effects. , 2003, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[2]  H. Ishii,et al.  Treatment effect of combined maxillary protraction and chincap appliance in severe skeletal Class III cases. , 1987, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[3]  L. Franchi,et al.  Predictive variables for the outcome of early functional treatment of Class III malocclusion. , 1997, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[4]  H. Baik.  Clinical results of the maxillary protraction in Korean children. , 1995, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[5]  Alex Jacobson,et al.  The "Wits" appraisal of jaw disharmony. , 2003, American journal of orthodontics.

[6]  S. Bishara.  Textbook of orthodontics , 2014 .

[7]  E. Tanaka,et al.  Craniofacial morphology in orthodontically treated patients of class III malocclusion with stable and unstable treatment outcomes. , 2000, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[8]  L. Graber,et al.  Chin cup therapy for mandibular prognathism. , 1977, American journal of orthodontics.

[9]  O G da Silva Filho,et al.  Early treatment of the Class III malocclusion with rapid maxillary expansion and maxillary protraction. , 1998, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[10]  H. Mitani.  Early application of chincap therapy to skeletal Class III malocclusion. , 2002, American Journal of Orthodontics and Dentofacial Orthopedics.

[11]  H. Kılıçoğlu,et al.  Profile changes in patients with class III malocclusions after Delaire mask therapy. , 1998, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[12]  U. Hägg,et al.  Long-term follow-up of early treatment with reverse headgear. , 2003, European journal of orthodontics.

[13]  P. Ngan.  Biomechanics of maxillary expansion and protraction in Class III patients. , 2002, American Journal of Orthodontics and Dentofacial Orthopedics.

[14]  J A McNamara,et al.  Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. , 1998, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[15]  R. Isaacson,et al.  A genetic study of class III malocclusion , 1970 .

[16]  J. McNamara.  An orthopedic approach to the treatment of Class III malocclusion in young patients. , 1987, Journal of clinical orthodontics : JCO.

[17]  H. Mitani,et al.  Long-term effects of chincap therapy on skeletal profile in mandibular prognathism. , 1990, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[18]  E. Gunel,et al.  Cephalometric variables to predict future success of early orthopedic Class III treatment. , 2005, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[19]  B. Thilander,et al.  The prevalence of malocclusion in Swedish schoolchildren. , 1973, Scandinavian journal of dental research.

[20]  G. V. Newman.  Prevalence of malocclusion in children six to fourteen years of age and treatment in preventable cases. , 1956, Journal of the American Dental Association.

[21]  Stanley Braun,et al.  Extraoral appliances: A twenty-first century update. , 2004, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[22]  V. Kokich,et al.  Experimental and postexperimental response to anteriorly directed extraoral force in young Macaca nemestrina. , 1979, American journal of orthodontics.

[23]  D. Joondeph.  Early orthodontic treatment. , 1993, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[24]  F. Melsen,et al.  The postnatal development of the palatomaxillary region studied on human autopsy material. , 1982, American Journal of Orthodontics.

[25]  Turley Pk.  Orthopedic correction of Class III malocclusion with palatal expansion and custom protraction headgear. , 1988 .

[26]  S J Chaconas,et al.  Biomechanical effects of maxillary protraction on the craniofacial complex. , 1987, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[27]  H. Mitani,et al.  Effects of chincap force on the timing and amount of mandibular growth associated with anterior reversed occlusion (Class III malocclusion) during puberty. , 1986, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[28]  H. Mitani,et al.  Predicting mandibular growth potential with cervical vertebral bone age. , 2003, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[29]  R. Behrents,et al.  Components of class III malocclusion in juveniles and adolescents. , 2009, The Angle orthodontist.

[30]  P. Ngan,et al.  Early Treatment of Class III Patients To Improve Facial Aesthetics and Predict Future Growth , 2004 .

[31]  O. Uner,et al.  Long-term evaluation after chincap treatment. , 1995, European journal of orthodontics.

[32]  P. Turley,et al.  Cephalometric effects of combined palatal expansion and facemask therapy on Class III malocclusion. , 1998, The Angle orthodontist.

[33]  T. Kambara.  Dentofacial changes produced by extraoral forward force in the Macaca irus. , 1977, American journal of orthodontics.

[34]  T. Deguchi,et al.  Stability of changes associated with chin cup treatment. , 2010, The Angle orthodontist.

[35]  S. Baek,et al.  Determinants of successful chincup therapy in skeletal class III malocclusion. , 2004, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[36]  R. Nanda.  Protraction of maxilla in rhesus monkeys by controlled extraoral forces. , 1978, American journal of orthodontics.

[37]  P. Sinclair,et al.  Cephalometric effects of face mask/expansion therapy in Class III children: a comparison of three age groups. , 1998, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[38]  S. Nakamura,et al.  Prediction of abnormal growth in class III malocclusions. , 1977, American journal of orthodontics.

[39]  B. Melsen.  Palatal growth studied on human autopsy material. A histologic microradiographic study. , 1975, American journal of orthodontics.

[40]  R. Nanda,et al.  The effects of chin cup therapy on the mandible: a longitudinal study. , 1984, American journal of orthodontics.

[41]  A. Björk,et al.  Normal and abnormal growth of the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. , 1983, European journal of orthodontics.

[42]  W. Bacon,et al.  Malocclusion in the deciduous dentition of Caucasian children. , 1997, European journal of orthodontics.

[43]  P. Ngan,et al.  Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction. , 1997, Seminars in orthodontics.

[44]  T. Rakosi,et al.  Class III anomalies: a coordinated approach to skeletal, dental, and soft tissue problems. , 1981, Journal of oral surgery.

[45]  U. Hägg,et al.  Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment. , 1996, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[46]  A. Uka,et al.  A roentgenocephalometric study of skeletal changes during and after chin cup treatment. , 1984, American journal of orthodontics.

[47]  E. Gunel,et al.  Cephalometric and occlusal changes following maxillary expansion and protraction. , 1998, European journal of orthodontics.