Major considerations of ortho-surgical procedures in Class III patients: a systematic review

Abstract

Introduction: In the setting of ortho-surgical procedure, malocclusion has a prevalence of about 6% in children in Brazil. Orthodontics excels in repair and cosmetic surgery. Most cases of Class III malocclusion have maxillary retrusion or hypoplasia, which may or may not be associated with mandibular prognathism. Objective: It was performed a systematic review to list the main considerations and clinical findings of ortho-surgical surgery in class III patients. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The present study was carried out from February to May 2022. The quality of the studies was based on the GRADE instrument, with randomized controlled clinical studies, prospective controlled clinical studies, and studies of systematic review and meta-analysis listed as the studies with the greatest scientific evidence, and the risk of bias was analyzed according to the Cochrane instrument. Initially, 289 articles were found and, after selection, 54 articles were used to compose the present study. Results and Conclusion: According to the objective of this study, the Class III treatment should be related to the diagnosis to correct the compromised structures, not done in places not affected by the malocclusion. Still, the degree of involvement of the maxilla and mandible must be evaluated so that the treatment is directed to that bone base for facial improvement. The displacement processes that occur in the midface can only be affected with treatment as long as the growth zones can respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects will be.