OBJECTIVETo evaluate dento-skeletal and soft-tissue profile changes after extraction of lower second molars and treatment using fixed appliances in severe class III subjects.

METHODSFourteen patients with severe skeletal class III malocclusion (male 4, female 10, age rang 12.0 - 17.1 years old, mean age 13.3 +/- 0.8), diagnosed as requiring orthognathic surgery, but rejected surgical therapy were included in the study. Lateral cephalometric films taken at the beginning and end of treatment were analyzed using Pancherz analysis and a traditional cephalometric analysis.

RESULTSAfter active treatment, inclination of lower incisors was decreased 11.7 degrees when measured to the mandibular plane (P < 0.001). A negative value of the distance between upper and lower lip position to SnPg' at the beginning of treatment changed to a positive value (P < 0.001).

CONCLUSIONSThe results of the current preliminary study suggest that success in the treatment of some severe class III deformity in the permanent dentition can be achieved with fixed appliances and extraction of lower second molars. A remarkable soft-tissue change was noted after the treatment and concave facial profiles changed to straight profiles.