Abstract

The purpose of this study was to retrospectively compare facemask therapy with either removable or fixed appliances for the treatment of skeletal class III patients in mixed dentition. Lateral cephalograms of 64 patients with skeletal Class III malocclusion, maxillary retrognathism were compared to evaluate skeletal, dentoalveolar and soft tissue changes pre- and post-treatment of facemask therapy with either removable or fixed appliances (n=32). A total of 31 angular and linear variables were used to analyze the cephalograms. All the measurements were done using Dolphin software Version 10.5. The paired T-test was performed to compare the cephalometric measurements before and after treatment in each treatment group. The Independent t-test was used to compare the changes in cephalometric measurements between two groups. P-value <0.5 was considered to indicate statistical significance. The SNA angle was increased significantly in both treatment groups (P value<0.05). The upper incisors were significantly proclined in both groups (P value<0.05) with a greater inclination in the fixed group. Mesial migration of maxillary first molar was greater in the removable group compared to the fixed group (P value<0.05)..Regarding mandibular skeletal and dental measurements, there was no significant difference between the two groups. The results of this study showed a significant orthopedic effect on the maxilla using facemask therapy with either fixed or removable appliances. The fixed appliance anchorage demonstrated better outcomes in terms of minimizing the loss of anchorage and greater maxillary protraction in the early mixed dentition which was mostly achieved by dentoalveolar movements rather than maxillary growth.

References

  • Allen RA, Connolly IH, Richardson A. (1993). Early treatment of Class III incisor relationship using the chincap appliance. The European Journal of Orthodontics. 15(5):371-6.
  • Anne Mandall N, Cousley R, DiBiase A, Dyer F, Littlewood S, Mattick R. (2012). Is early class III protraction facemask treatment effective? A multicentre, randomized, controlled trial: 3-year follow-up. Journal of orthodontics. 39(3):176-85. https://doi.org/10.1179/1465312512Z.00000000028
  • Arman A, Toygar TU, Abuhijleh E. (2004). Profile changes associated with different orthopedic treatment approaches in Class III malocclusions. The Angle Orthodontist. 74(6):733-40.
  • Arman A, Toygar TU, Abuhijleh E. (2006). Evaluation of maxillary protraction and fixed appliance therapy in Class III patients. The European Journal of Orthodontics. 28(4):383-92.
  • Cevidanes L, Baccetti T, Franchi L, McNamara Jr JA, De Clerck H. (2010). Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion. Angle Orthodontist. 80(5):799-806.
  • Cha K-S. (2003). Skeletal changes of maxillary protraction in patients exhibiting skeletal class III malocclusion: a comparison of three skeletal maturation groups. The Angle Orthodontist. 73(1):26-35.
  • Cozza P, Baccetti T, Mucedero M, Pavoni C, Franchi L. (2010). Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in Class III malocclusion. American journal of orthodontics and dentofacial orthopedics. 138(3):300-10.
  • Cozza P, Marino A, Mucedero M. (2004). An orthopaedic approach to the treatment of Class III malocclusions in the early mixed dentition. The European Journal of Orthodontics. 26(2):191-9.
  • Delaire J, Verdon P, Lumineau J, Cherga-Negrea A, Talmant J, Boisson M. (1972). Some results of extra-oral tractions with front-chin rest in the orthodontic treatment of class 3 maxillomandibular malformations and of bony sequelae of cleft lip and palate. Revue de stomatologie et de chirurgie maxillo-faciale. 73(8):633.
  • Delaire J, Verdon P. (1983). The use of heavy postero-anterior extraoral forces by an orthopedic mask in the treatment of dentomaxillary sequellae of labiomaxillopalatal clefts. Chirurgie pediatrique. 24(4-5):315-22.
  • Ellis III E, McNamara Jr JA. (1984). Components of adult Class III malocclusion. Journal of Oral and Maxillofacial Surgery. 42(5):295-305.
  • Gallagher R, Miranda F, Buschang P. (1998). Maxillary protraction: treatment and posttreatment effects. American Journal of Orthodontics and Dentofacial Orthopedics. 113(6):612-9.
  • Guyer EC, Ellis III EE, McNamara Jr JA, Behrents RG. (1986). Components of Class III malocclusion in juveniles and adolescents. The Angle Orthodontist. 56(1):7-30.
  • Hardy DK, Cubas YP, Orellana MF. (2012). Prevalence of angle class III malocclusion: A systematic review and meta-analysis. Open Journal of Epidemiology. 2(04):75. https://doi.org/10.4236/ojepi.2012.24012
  • Hino CT, Cevidanes LH, Nguyen TT, De Clerck HJ, Franchi L, McNamara Jr JA. (2013). Three-dimensional analysis of maxillary changes associated with facemask and rapid maxillary expansion compared with bone anchored maxillary protraction. American Journal of Orthodontics and Dentofacial Orthopedics. 144(5):705-14.
  • Jacobson A, Evans W, Preston C, Sadowsky P. (1947). Mandibular prognathism. American journal of orthodontics. 66(2):140-71. https://doi.org/10.1016/0002-9416(74)90233-4
  • Jamilian A, Showkatbakhsh R, Taban T. (2012). The effects of fixed and removable face masks on maxillary deficiencies in growing patients. ORTHODONTICS: The Art & Practice of Dentofacial Enhancement. 13(1).
  • Kapust AJ, Sinclair PM, Turley PK. (1998). Cephalometric effects of face mask/expansion therapy in Class III children: a comparison of three age groups. American Journal of Orthodontics and Dentofacial Orthopedics. 113(2):204-12.
  • Kitai N, Takada K, Yasuda Y, Adachi S, Hirase E, Kitaguchi T. (1990). Prevalence of malocclusions and demand for orthodontic treatment among students at a women’s high school. [Osaka Daigaku shigaku zasshi] The journal of Osaka University Dental Society. 35(1):321-7.
  • Lin J. (1985). Prevalence of malocclusion in Chinese children age 9-15. Clin Dent. 5:57-65.
  • Morales-Fernández M, Iglesias-Linares A, Yañez-Vico RM, Mendoza-Mendoza A, Solano-Reina E. (2012). Bone-and dentoalveolar-anchored dentofacial orthopedics for Class III malocclusion: new approaches, similar objectives? A systematic review. The Angle orthodontist. 83(3):540-52.
  • Nanda R. (1980). Biomechanical and clinical considerations of a modified protraction headgear. American Journal of Orthodontics. 78(2):125-39. https://doi.org/10.1016/0002-9416(80)90055-X
  • Nartallo-Turley PE, Turley PK. (1998). Cephalometric effects of combined palatal expansion and facemask therapy on Class III malocclusion. The Angle orthodontist. 68(3):217-24.
  • Ngan P, Hägg U, Yiu C, Merwin D, Wei SH. (1996). Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 109(1):38-49.
  • Ngan P, Moon W. (2015). Evolution of Class III treatment in orthodontics. American Journal of Orthodontics and Dentofacial Orthopedics. 148(1):22-36.
  • Perillo L, Vitale M, Masucci C, D’Apuzzo F, Cozza P, Franchi L. (2015). Comparisons of two protocols for the early treatment of Class III dentoskeletal disharmony. European journal of orthodontics. 38(1):51-6.
  • Rakosi T, Schilli W. (1981). Class III anomalies: a coordinated approach to skeletal, dental, and soft tissue problems. Journal of oral surgery (American Dental Association: 1965). 39(11):860.
  • Ramezanzadeh B, Hosseiny S. (2005). Evaluation of prevalence of dental malocclusion in students of junior high school students in the city of Neishabour in year 2002-2003. J of Mashhad Dental School. 29(Issue):57-66.
  • Ravindra N. (2015). Esthetics and Biomechanics in orthodontics. Elsevier.
  • Roberts CA, Subteiny JD. (1988). An american board of orthodontics ease report, use of the face mask in the treatment of maxillary skeletal, retrusion. American Journal of Orthodontics and Dentofacial Orthopedics. 1988;93(5):388-94. https://doi.org/10.1016/0889-5406(88)90097-2
  • Sami S, Marin E. (2017). Simulation of Solar Photovoltaic, Biomass Gas Turbine and District Heating Hybrid System. International Journal of Sustainable Energy and Environmental Research, 6(1): 9-26.
  • Şar Ç, Şahinoğlu Z, Özçırpıcı AA, Uçkan S. (2014). Dentofacial effects of skeletal anchored treatment modalities for the correction of maxillary retrognathia. American Journal of Orthodontics and Dentofacial Orthopedics. 145(1):41-54.
  • Showkatbakhsh R, Jamilian A, Behnaz M. (2011). Treatment of maxillary deficiency by miniplates: a case report. ISRN surgery. https://doi.org/10.5402/2011/854924
  • Showkatbakhsh R, Jamilian A, Ghassemi M, Ghassemi A, Taban T, Imani Z. (2012). The effects of facemask and reverse chin cup on maxillary deficient patients. Journal of orthodontics. 39(2):95-101.
  • Tortop T, Kaygisiz E, Erkun S, Yuksel S. (2017). Treatment with facemask and removable upper appliance versus modified tandem traction bow appliance: the effects on mandibular space. European journal of orthodontics. 40(4):372-7.
  • Westwood PV, McNamara Jr JA, Baccetti T, Franchi L, Sarver DM. (2003). Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances. American journal of orthodontics and dentofacial orthopedics. 123(3):306-20.
  • Williams S, Aarhus CA. (1986). The morphology of the potential Class III skeletal pattern in the growing child. American Journal of Orthodontics. 89(4):302-11.
  • Yoshida I, Ishii H, Yamaguchi N, Mizoguchi I. (1999). Maxillary protraction and chincap appliance treatment effects and long-term changes in skeletal Class III patients. The Angle Orthodontist. 69(6):543-52.

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.