Orthopedic Treatment Of Class Research Articles

Stability prediction of early orthopedic treatment in Class III malocclusion: morphologic discriminant analysis

BackgroundTo evaluate morphologic differences between class III malocclusion success and failure treatment subjects in order to identify which variables are more predictive for long-term stability in early orthopedic treatment. In this retrospective study, 31 patients were enrolled from the Department of Orthodontics (Rome Tor Vergata). Inclusion criteria were as follows: white ancestry, class III malocclusion, mixed dentition, cervical stage (CS) 1-2, no pseudo-class III. Pre-treatment radiographic and cast records were collected. Each patient underwent rapid maxillary expansion/facial mask/bite block (RME/FM/BB) orthopedic treatment until correction. At T1 (permanent dentition, CS4), records were recollected. According to treatment stability, relapse group (RG, 19) and success group (SG, 12) were identified. Sagittal and vertical cephalometric and digital cast measurements were performed. Student’s t tests were used for statistically significant differences inter and intra groups. For discriminant analysis, relapse or success status was added to each patient’s T0 data.ResultsAt T0, RG showed larger upper anterior transversal width (p = 0.0266), while at T1 the upper anterior length was shorter than SG (p = 0.0028). Between T1 and T0, both groups showed larger upper anterior and posterior transversal widths. SG had greater upper anterior (p = 0.0066) and posterior (p = 0.449) sagittal length. RG presented larger lower anterior (p = 0.0012) and posterior (p = 0.0002) transversal widths, while there were no differences in SG lower arch. Discriminant analysis provided two predictive variables with an accuracy of 80.6%: upper anterior length and upper posterior length.ConclusionA shorter and wider maxilla could be a predisposing factor for relapse and failure of the early orthopedic treatment of class III malocclusion patients. The absence of mandibular changes could be predictable for treatment success.

Early treatment of Class III malocclusion with a tandem traction bow appliance

Since Class III malocclusion is progressive in nature, the facial growth of Class III malocclusion worsens with age. Class III malocclusion is associated with a deviation in the sagittal relationship of the maxilla and the mandible, characterized by a deficient maxilla, retrognathic mandible, or a combination of both. The early orthopedic treatment of Class III malocclusions, at the end of primary dentition or the beginning of mixed dentition, prior to growth spurt, allows the accomplishment of successful results, providing facial balance, modifying the maxillofacial growth and development, and in many instances, preventing a future surgical treatment by increasing the stability. Many treatment approaches can be found in the literature regarding orthopedic and orthodontic treatment of Class III malocclusion, including intra- and extra-oral appliances. The major problem with extraoral anchorage has been of patient compliance due to its physical appearance. The case report presents an intraoral modified tandem appliance for maxillary protraction that has been used clinically to achieve successful results without relying much on patient co-operation.

Prevalence of malocclusion and need for early orthodontic treatment in children.

With the advent of functional appliances and orthopedic appliances the elimination and correction of skeletal and dental discrepancies has been much reduced. Most orthodontists agree that elimination of oral habits and orthopaedic treatment of class 3 malocclusion and posterior cross bites deserve treatment at an early age. Early treatment was proposed along the lines of "catch them in the young", and "you see it, you treat it" is the main ideology of Early Orthodonticc Treatment (EOT). Furthermore, the majority of children have habits driving the malocclusion. Mouth breathing, tongue thrusting and incorrect swallowing patterns are all known causes of malocclusion and poor facial growth. To evaluate the prevalence of dental feature that might result in malocclusion and need for early orthodontic treatment. Groups of 532 school going children were selected and complete case history was taken and were categorized based on the type of malocclusions, dental features that can predetermine need for early orthodontic treatment. Statistical analysis used. The results shows the increase in prevalence of malocclusion and the dental features that gives clues for an orthodontist to frame up his treatment modalities not just for corrective orthodontics but for also preventive and interceptive orthodontics. Angle's Class I malocclusion is most commonly seen malocclusion followed by class II division 1 malocclusion followed by Angles class II division 2 malocclusion. In angle's class I malocclusion, incidence of crowding is more followed by proclination of anterior teeth. There is no significant difference between incidence of malocclusion in males and females. The children who needed immediate orthodontic care were more than the children who doesn't need an orthodontic treatment. Need for increase of awareness programs is required in order to educate the people about the early orthodontic treatment.

Orthopedic treatment of Class III malocclusion with rapid maxillary expansion combined with a face mask: a cephalometric assessment of craniofacial growth patterns

Objective: The aim of this prospective study was to assess potential changes in the cephalometric craniofacial growth pattern of 17 children presenting Angle Class III malocclusion treated with a Haas-type expander com- bined with a face mask. Methods: Lateral cephalometric radiographs were taken at beginning (T 1 ) and immediately after removal of the ap- pliances (T 2 ), average of 11 months of treatment. Linear and angular measurements were used to evaluate the cranial base, dentoskeletal changes and facial growth pattern. Results: The length of the anterior cranial base experienced a reduction while the posterior cranial base assumed a more vertical position at T 1 . Some maxillary movement occurred, there was no rotation of the palatal plane, there was a slight clockwise rotation of the mandible, although not significant. The ANB angle increased, thereby im- proving the relationship between the jaws; dentoalveolar compensation was more evident in the lower incisors. Five out of 12 cases (29.41%) showed the following changes: In one case the pattern became more horizontal and in four cases more vertical. Conclusions: It was concluded after a short-term assessment that treatment with rapid maxillary expansion (RME) associated with a face mask was effective in the correction of Class III malocclusion despite the changes in facial growth pattern observed in a few cases.