Skeletal, Dental, and Soft Tissue Changes after Applying Active Skeletonized Sutural Distractor (ASSD) for Class III Malocclusion Patients

Rozita Hassan,Wael Ahmed Bayomy Mohamed,Norma Ab Rahman,Norkhafizah Saddki,Shaifulizan Ab Rahman

doi:10.3390/app12031233

Rozita Hassan, Wael Ahmed Bayomy Mohamed + Show 3 more

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https://doi.org/10.3390/app12031233

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Abstract

Background: Nonsurgical treatment of Class III malocclusion may reduce the chances for orthognathic surgery in the future. This study aimed to determine the post-treatment skeletal, dental and soft tissue changes in the anteroposterior plane applying active skeletonized sutural distractor (ASSD) in late adolescent Class III malocclusion patients. Materials and Methods: After screening 13,500 students from 18 secondary schools, a sample of 26 subjects was recruited for this study, with a mean age of 15(±1.4) years after considering the inclusion and exclusion criteria. ASSD appliances were inserted into patients, and lateral cephalometric x-rays were taken for pre- and post-treatment analysis. Dental casts of the patients were also taken and scanned using a 3D laser scanner for comparisons. Results: The intraclass correlation coefficients (ICC) for inter-examiner were 0.87 to 0.99 and 0.96 to 0.99 for lateral cephalometric and dental cast measurements, respectively. The difference in pre- and post-treatment of cephalometric measurements of the mandible showed statistically significant changes for mandibular plane angle (p < 0.001) and SNB angle (p = 0.029). The dental cast measurements showed statistically significant changes of inter-molars width (p < 0.001) as well as palatal (p = 0.002). Conclusions: The results showed statistically significant improvement in skeletal, dental, and soft tissue changes after treatment applying ASSD for Class III malocclusion patients.

Highlights

Class III malocclusion is caused by either the deficient growth of the maxilla in the downward and forward direction or excessive growth of the mandible and is considered one of the most difficult cases in orthodontics
In a study conducted by Soh et al [1] to evaluate the occlusal status of an Asian population in Malaysia among the sample of male army recruits (N 339, age 17–22 years), they found that the highest prevalence of Class III malocclusion was in Malay 26.67%
The study group consisted of 26 children treated with active skeletonized sutural distractor (ASSD) appliance (11 males, 15 females) with a mean age of 15(±1.4) years

Summary

Introduction

Class III malocclusion is caused by either the deficient growth of the maxilla in the downward and forward direction or excessive growth of the mandible and is considered one of the most difficult cases in orthodontics. Nonsurgical treatment of Class III malocclusion remains a challenge. In a study conducted by Soh et al [1] to evaluate the occlusal status of an Asian population in Malaysia among the sample of male army recruits (N 339, age 17–22 years), they found that the highest prevalence of Class III malocclusion was in Malay 26.67%. There were some case reports that proved that face masks can still have favorable treatment effects when the patient is over 15 years [3,4]

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