Class III malocclusion patients can be approached with many different types of treatment methods, and thus, each patient's problems must be accurately evaluated to allow selection of the best possible treatment method. Cephalometric analysis is an essential part of diagnosis and treatment planning of orthodontic patients, and it would certainly be helpful if reliable cephalometric guidelines could be set. The author divided 482 Class III malocclusion patients(253 males and 229 females) into fourgroups according to different types of treatment methods they have received to correct imbalance between upper and lower jaws: 1) orthopedic appliance (face mask & RPE), 2) camouflage treatment with fixed appliance, 3) surgical-orthodontic treatment, 4) cross-bite correction with removable plates/ functional appliance. Cephalometric values at the time of first clinical examination were compare among the four groups. Cephalometric analysis indicates the following results: 1)the amounts of antero-posterior and vertical skeletal discrepancies and dental compensation were greatest in surgery group 2) SNB, Wits, distance from Nasion Perpendicular Plane to point a facial angle, facial convexity, and APDI were greater in orthopedic appliance group than fixed appliance(camouflage) group, but there was no statistical difference 3) removable plates/ functional appliance group showed least amounts of skeletal discrepancies and dental compensation with statistical significance.
Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.
The purpose of this study is to define the characteristics of the skeleton and soft tissues of severe adult class III malocclusion. The materials selected for this study were lateral cephalograms of 112 adult class III malocclusion patients with ANB difference below -2 degrees. and the mean age was 22.9 years old. The normal control sampler consisted of lateral cephalograms of 50 adults in normal occlusion and the mean age was 22.1 years old. The Horizontal reference line was FH line and the vertical reference line was nasion perpendicular to FH line. The skeletal and soft tissue characteristics of Class III malocclusion are as follows : 1. In the skeletal profile evaluated by vertical reference line (Nasion perpendicular to FH), the forehead and maxilla was similar to normal, but the mandible was protruded significantly. 2. The soft tissue profile is concave. The thickness of soft tissue covering forehead area and nose is within normal range. but the upper lip is thicker and the nasolabial angle is smaller than normal. The lower lip and inferior labial sulcus is thinner than normal. The degree of eversion of lower lip is lesser than normal. 3. The cranial base of class III malocclusion is shorter and saddle angle is smaller than normal. 4. The location of midface evaluated in relations to cranial base is within normal range but, the length of midface is shorter than normal when compared from the deep portion of the facial skeleton. 5. The location of maxilla in reference to cranial base is within normal range but the length of maxilla was shorter in class III malocclusion. 6. The mandible was protruded, ramus height and body length, gonial angle were greater than normal, and the chin angle was smaller. 7. Upper incisor was proclined, lower incisor was retroclined.
The purpose of this study was to investigate if there were a significant difference between cephalometric measurements of mandibular position derived from a centric occlusion tracing compared to those of a converted centric relation tracing in the Class III malocclusion. The sample consisted of 25 Class III malocclusion and 25 normal occlusion persons who had no orthodontic treatment. The records included an lateral cephalometrics in centric occlusion, centric relation and centric occlusion bite registration and diagnostic casts mounted on the SAM II articulator in CR. The amount of CR-CO discrepancy of condyle was recorded using a MPI(Mandibular Position Indicator, MPI $200^{(R)}$, Great Lakes Orthodontics, USA). The conversion of the CO cephalogram to CR using the MPI readings was performed on the Conversion work sheet. Measures of mandibular position were chosen for the purpose of this study. The comparison of the difference between CO and CR cephalometric measurements in the normal occlusion and Class III malocclusion group were studied. The results were as follows: 1. In the features of CR-CO discrepancy of the condyle, the condyle was displaced posterior and inferior when the teeth were in centric occlusion. The horizontal component(${\Delta}X$) in Class HI malocclusion group was greater than the vertical component(${\Delta}Z$) and also greater than the horizontal component(${\Delta}X$) in normal occlusion group. There was no statistically significant correlation between MPI measurements and the groups of normal occlusion and Class III malocclusion group. 2. In the comparison of the cephalometric measurements in each group, Normal occlusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity and ODI. Class HI malocclusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity, ODI, SNB, APDI, L1-FP and it had more significance than the normal occlusion group. 3. The Value of cephalometric measurements was significantly different between CO and CR but there were no differences between the groups of normal occlusion and Class III malocclusion. The results of this study suggest that if the discrepancies are greater than the amount of normal displacement from clinically captured centric relation, centric relation should be considered as the starting point for proper diagnosis and treatment planning.
Journal of the korean academy of Pediatric Dentistry
/
v.35
no.2
/
pp.235-242
/
2008
The purpose of this study was to investigate the relationship of the skeletal maturity of hand-wrist and the development of mandibular third molar in subjects with class I and class III malocclusion. The subjects used in this study were 304 children(149 boys, 155 girls) with class I malocclusions and 308 children( 153 boys, 155 girls) with class III malocclusions, ranged from 8 to 15 years of age. Hand-wrist radiographs and panoramic radiographs were used to evaluate the stage of skeletal maturity and teeth development. Fishman's method for the skeletal maturity stages of the hand-wrist and new six-developmental-stage method for the calcification stages of mandibular third molars were analyzed. The results were as follows : 1. In subjects with class I and class III malocclusion, skeletal maturity of the hand-wrist occured earlier in females than in males(p<0.05), while the calcification stages of mandibular third molars were no significant gender differences. 2. There were no significant differences between the groups, when comparing the skeletal maturity stages of the hand-wrist and the calcification stages of mandibular third molars between subjects with the class I and the class III malocclusion. 3. The correlation coefficients between the calcification stages of mandibular third molars and the skeletal maturity stages of the hand-wrist in subjects with class I and class III malocclusion showed a high interrelationship(p<0.01). 4. The correlation coefficients between the calcification stages of mandibular third molars and chronological age in subjects with class I and class III malocclusion showed a high interrelationship (p<0.01). As a result, there were no significant differences between class I and class III malocclusion group for skeletal maturity of the hand-wrist and third molar development.
This study was made with lateral cephalometric radiography of 28 skeletal class III malocclusion patients that were performed to setback surgery of mandible. The 28 patients were selected by four standards as follows. 1) Set-back amount of mandible is below 10 mm 2) No extrusion and intrusion of posterior tooth or alteration of interincisial angle at period of postoperative orthodontic treatment. 3) Change of mesial segment location of mandible on lateral cephalometrics 4) No genioplasty And 28 patients were divided to three group(1,2,3 group) by degree of preoperative occlusal plane angle to Burstone's horizontal plane. The preoperative occlusal plane angle, which of 1 group was smaller than $7^{\circ}$ and 2 group was between $7^{\circ}$ to $15^{\circ}$ and 3 group was larger than $15^{\circ}$. The results were as follows : 1. As the preoperative occlusal plane angle was larger, the degree of mandibular prognathism was not severe. 2. On comparsion of preoperative and immediate postoperative cephalometric analysis, specific relationship of occlusal plane angle and set-back amount of mandible was not present. 3. As the preoperative occlusal plane angle was smaller, the alteration of postoperative occlusal plane angle was increased tendency. As the preoperative occlusal plane angle was larger, the alteration of postoperative occlusal plane angle was decreased tendency. 4. The relapsed degree of B point distance to Vertical plane was not relationship to the degree of preoperative occlusal plane angle.
The aims of this study were to investigate the differences in the early craniofacial morphology of Class III malocclusions with good, fair and poor occlusal stability and to elucidate a key determinant for distinguishing the cases. Lateral cephalograms of 30 subjects with Class III malocclusion in the mixed dentition were analyzed at the start of treatment (mean age of $8.58\pm1.47$). All subjects were reevaluated after a mean period of $7.50\pm1.94$ years comprising active treatment and retention. At this time, the samples were divided into three groups: good (10 subjects), fair (10 subjects) and poor (10 subjects) occlusal stability groups. According to the results of ANOVA, there were significant morphological differences in the early stage among the good, fair and poor occlusat stability groups, especially in variables that represented the vertical skeletal relationships. As well, there were already more dental compensations in the poor occlusal stability group. Stepwise discriminant analysis on the measurements at the time of first observation identified only one predictive variable: AB to mandibular plane angle(AB-MP). With this discriminant function, $83.3\%$of the original grouped cases were correctly classified and the canonical correlation coefficient was 0.857. In conclusion, AB-MP can be a possible predictor for the eventual prognosis of early Class III treatment. If it is below 60, the prognosis of early Class III treatment is expected to be poor, while if it is above 65, a good prognosis is expected.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.28
no.1
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pp.24-30
/
2002
The facial patterns were expressed by the interrelation of variable factors such as heredity, function and environment. Such variable factors have an effect on the growth and development of maxillofacial bones. The malocclusions with skeletal discrepancies are caused by abnormal forms, sizes and positions of cranial base, maxilla and mandible. For the proper diagnosis and treatment planning, the analysis of such structures is necessary. Lateral cephalograms of 54 adults with class III malocclusion patients (test group) and 61 adults with normal occlusion (control group) were analyzed. Anteroposterior relations and sizes of cranial base, maxilla, mandible were estimated to compare with those of normal ones. In test group, the anterior cranial base length was within normal range, but posterior cranial base, maxilla and mandibular body were longer than those in control group, significantly. Based on the cranial base, the location of maxilla in test group was normal, but the location of mandible was more anterior than that in control. Based on the maxilla, the location of mandible was more anterior in test group than that in control. Both mandibular body and ramus anteroposterior lengths in test group were larger than those in control. Both mandibular plane angle and upper gonial angle were within normal range, but lower gonial angle was significantly high in test group.
Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.
Sella turcica contains pituitary gland that has influence on craniofacial growth. So, if the volume of sella turcica correlate to the function of Pituitary gland, we can assume that the volume of sella turcica in skeletal Class III patients has some difference to that of normal occlusion group. The purpose of this study was to evaluate the difference of shape and volume of sella turcica between normal occlusion group and Class III patients. The shape of sella turcica was Classified by Inaba method and the volume of sella turcica was measured in lateral and P-A cephalograms by Di Chiro method. To find out the possibility of the volume of sella turcica as diagnostic aid to predict Class III growth pattern, the correlation coefficients between the volume of sella and cephalometric variables were calculated. The results were as follows. 1. The volume of sella turcica in Class III patients is larger than that of normal occlusion groups 2. The volume of sella turcica in female was larger than that of male in Class III patients 3. The volume of sella turcica has close correlation with APDI, ANB, SNA, SNB, ODI, gonial angle, post. cranial base length 4. Sella Index (volume of sella / ant. cranial base length) can be a more accurate indicator that represent Class III growth pattern than volume of sella itself. 5. The morphologic pattern of sella turcica had no significant difference between two groups.
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