Main approaches of three-dimensional (3D) imaging examinations in the assessment, treatment, and follow-up of patients with skeletal Class III: a concise systematic review

Abstract

Introduction: Class III malocclusion presents with several skeletal and dental factors, highlighting the large or protruding jaw, retrusive maxilla, protrusive mandibular dentition, retrusive maxillary dentition, or combinations. The importance of evaluating class III malocclusions, as well as their treatments, through three-dimensional (3D) images are highlighted. Objective: To present a concise systematic review of the approach of 3D imaging exams to conduct class III malocclusion treatments, as well as to follow up after orthognathic surgery. Methods: Clinical studies with qualitative and/or quantitative analysis were included, following the rules of the systematic review-PRISMA. Results and Conclusion: A total of 105 articles was found involving class III malocclusion and ortho-surgical treatments guided by three-dimensional (3D) images. A total of 44 articles were fully evaluated and 16 were included and discussed in this study. Positional, structural, and volumetric condylar changes after orthognathic surgery in skeletal Class III patients have been well elucidated using cone-beam computed tomography. In addition, the virtual surgical planning and the surgical splint manufactured in CAD/CAM facilitate treatment planning and offer an accurate surgical result in orthognathic surgery. The application of pre-engineered bone guidance splints allows the treatment of craniofacial deformities with precision. Therefore, the three-dimensional (3D) tool allows for the accuracy of treatments and planning of orthognathic surgery, as well as the best postoperative follow-up.