OBJECTIVETo analyze effects of non-surgical treatment on subjects of 12-20 years old with severe skeletal Class III deformity and to directly evaluate dental and facial profile changes.

METHODSEighteen patients with severe skeletal Class III malocclusion (male 5, female 13), diagnosed as indication for orthognathic surgery, were included in the study. The average age was 14.6 +/- 2.5 years old., with age range from 12 years old to 20 years old. 12 cases were treated with Tip-Edge straight-wire technique and 6 cases with Begg light wire technique. The average treatment time was 2.5 +/- 0.8 years. The selection criteria included: (1) mesial or superior mesial Class III molar relationship, with maxillary first molar occlude the buccal groove of the mandibular second molars (2) no mandibular shift (3) ANB < -1.5 degrees (4) high angle cases with average value of SN-MP 34.9 degrees +/- 5.9 degrees, 4 cases present with openbite (5) concave facial profile (6) originally classified as surgery cases. Lateral cephalometric films taken at the beginning and the end of the treatment were analyzed with traditional cephalometric analysis. The arithmetic mean (Mean) and standard deviation (SD) were calculated for each variable. Paired t-test was performed to evaluate the significant treatment change.

RESULTSNormal overjet and overbite were established with proclination of upper incisors and retroclination of lower incisors. Inclination of upper incisors was increased 5.9 degrees when measured with the angle of upper incisor to SN plane (P < 0.01). Inclination of lower incisors was decreased 6.6 degrees when measured with the angle of lower incisor to mandibular plane (P < 0.001). Negative value of the distance difference of upper lip and lower lip to Sn-Pg' at the beginning of treatment changed to positive value with significant difference (P < 0.001).

CONCLUSIONSuccessful treatment effects could be obtained with non-surgical therapy in severe skeletal Class III malocclusion in permanent dentition. Remarkable soft-tissue change was noted after the treatment and concave facial profile changed to straight profile.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Malocclusion, Angle Class III ; therapy ; Orthodontics, Corrective

Adult ; Humans ; Malocclusion, Angle Class III ; therapy ; Orthodontics ; Orthodontics, Corrective ; methods ; Preoperative Care ; methods

OBJECTIVE: To use the cone-beam computed tomography (CBCT) to evaluate the three-dimensional (3D) changes of maxillary landmarks in the maxillary protraction with alternating rapid palatal expansion and constriction and with rapid palatal expansion, and to provide some clinical suggestions for the early treatment of Class III malocclusion. METHODS: A total of 36 maxillary retrusive patients were included and randomized in a 1:1 ratio to either the intervention group (alternating rapid palatal expansion and constriction group, RPE/C) or the control group (rapid palatal expansion group, RPE). Randomization was accomplished with permuted block randomization based on participation sequence. The patients in the RPE/C were treated for 10 weeks (0.5 mm/d) with the repetition of two-week palatal expansion and two-week palatal constriction. The patients in the RPE were taught to complete rapid palatal expansion for 2 weeks (0.5 mm/d ). The patients were instructed to come to the office for the follow-up to ensure the correct procedures. Damaged expanders were repaired (or replaced) and rebanded quickly. Sequential CBCT images including pretreatment (T1), post-expansion (T2) and post-protraction (T3) were required for 3D reconstruction, establishment of landmarks, measurement and analysis by Mimics 10.01. RESULTS: There was significant forward movement of subspinale (A) in the RPE/C after the treatment with (3.06±1.29) mm, compared with RPE (2.16±1.27) mm, P<0.05. There were more symmetrical changes of the landmarks in the RPE/C and there was no statistic significance of the entire treatment time between the two groups. Moreover, the maxillary skeletal landmarks had the following 3D changes of a forward and downward movement during the expansion stages T2-T1, a forward and upward movement during the protraction stages T3-T2 and a forward and downward movement during the total treatments T3-T1 compared with the control group. And the width between the bilateral landmarks increased during the expansion stages T2-T1, narrowed down during the protraction stages T3-T2 and increased during the total treatments T3-T1. CONCLUSION The maxillary protraction with alternating rapid palatal expansion and constriction provided clinical benefits on maxillary advancement and symmetrical changes in the orthopedic treatment of the patients with maxillary retrognathism and it required further study on the orthodontic analysis and measurements of CBCT.
Cephalometry ; Cone-Beam Computed Tomography ; Constriction ; Humans ; Malocclusion, Angle Class III/therapy* ; Maxilla ; Palatal Expansion Technique

This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources: study casts (SC), lateral cephalometric X-ray images (LX) and facial photographs (PH) were generated at the end of treatment for 108 patients selected randomly from six orthodontic treatment centers throughout China. Six different assessments of treatment outcome were made by each orthodontist using data from the three information sources separately and in combination. Each assessment included both ranking and grading for each patient. The rankings of each of the 69 judges for the 108 patients were correlated with the rankings of each of the other judges yielding 13 873 Spearman rs values, ranging from -0.08 to +0.85. Of these, 90% were greater than 0.4, showing moderate-to-high consistency among the 69 orthodontists. In the combined evaluations, study casts were the most significant predictive component (R(2)=0.86, P<0.000 1), while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment (R(2)=0.96, P<0.000 1). Grading scores for SC+LX and SC+PH were highly significantly correlated with those for SC+LX+PH (r(SC+LX)vs.(SC+LX+PH)=0.96, r(SC+PH)vs.(SC+LX+PH)=0.97), showing that either SC+LX or SC+PH is an excellent substitute for all three combined assessment.
Adolescent ; Cephalometry ; standards ; China ; Dental Models ; standards ; Esthetics, Dental ; Female ; Humans ; Male ; Malocclusion, Angle Class I ; therapy ; Malocclusion, Angle Class II ; therapy ; Malocclusion, Angle Class III ; therapy ; Orthodontics ; standards ; Peer Review, Health Care ; standards ; Photography ; standards ; Reproducibility of Results ; Treatment Outcome

Fingersucking ; adverse effects ; Humans ; Malocclusion ; etiology ; therapy ; Malocclusion, Angle Class II ; therapy ; Malocclusion, Angle Class III ; therapy ; Orthodontic Brackets ; Orthodontics, Corrective ; methods ; Orthodontics, Interceptive ; methods ; Palatal Expansion Technique ; Time Factors ; Tongue Habits ; adverse effects ; Tooth Extraction ; Tooth, Impacted ; surgery

OBJECTIVEThe purpose of this study is to evaluate the methods of treatment on Class III malocclusion with mandibular deviations, and clarify the principles of expansion and multiloop edgewise arch wire technique.

METHODS8 skeletal class III with mandibular deviations patients were selected (male 3, female 5, aged 12-18). They were all corrected with maxillary expansion and multiloop edgewise arch wire technique.

RESULTSIn all cases, molar relationships were class I, the overbite and the overjet were normal, and the upper and lower midline were harmony.

CONCLUSIONMild and moderate skeletal class III with mandibular deviation can be corrected successfully by maxillary expansion and multiloop edgewise arch wire technique.

Adolescent ; Child ; Dental Occlusion ; Female ; Humans ; Male ; Malocclusion, Angle Class III ; therapy ; Mandible ; abnormalities ; Orthodontic Wires ; Palatal Expansion Technique

OBJECTIVETo analyze the mechanics in correction of skeletal class III malocclusion with Multiloop Edgewise Arch Wire (MEAW).

METHODS15 patients with skeletal class III malocclusion were treated with MEAW technique. Cephalometric analysis was performed with pre-treatment and post-treatment cephalograms. Paired t-test was conducted to assess the treatment effects.

RESULTSL6-XI decreased by 2.87 mm, L6/MP increased by 8.60 degrees, L1-XI decreased by 2.60 mm, OP/MP increased by 2.33 degrees. Skeleton changed a little. There was no significant change in the soft tissue.

CONCLUSION(1) Dento-alveolar compensation is the main change after the treatment by MEAW technique; (2) The improvement in molar relationship and overjet is achieved with upright and distal movement of the lower posterior teeth; (3) The lower anterior teeth moved lingually and protracted. Occlusal plane is flattened.

Adolescent ; Adult ; Cephalometry ; Dentition, Permanent ; Female ; Humans ; Male ; Malocclusion, Angle Class III ; therapy ; Orthodontic Wires ; Orthodontics, Corrective ; methods

OBJECTIVEThe skeletal Class III malocclusion often occurs in ethnic Asia population, and it is difficult to obtain an ideal results if only treated with protraction headgear (PH). However, the combined rapid palatal expansion (RPE), Edgewise Technique and PH can reach it, so the authors investigated the methods and characteristics of combined RPE, Edgewise Technique and PH in the treatment of skeletal Class III malocclusion.

METHODSFifteen patients, aged 8.5-12 years, including six males and 9 females, with skeletal Class III malocclusion and maxillary retrusion were selected for this study. Radiographs of left hand and wrist showed that all patients were at the pre-pubertal stage. The duration of treatment was nine months on average.

RESULTSThe SNA and A-ptm increased with a mean of cephalometric analysis, which showed significant difference (P < 0.05).

CONCLUSIONObvious skeletal and profile changes can be achieved with combined RPE, Edgewise Technique and PH in the treatment of early skeletal Class III malocclusion.

Child ; Extraoral Traction Appliances ; Female ; Humans ; Male ; Malocclusion, Angle Class III ; therapy ; Orthodontics, Corrective ; instrumentation ; methods ; Palatal Expansion Technique

OBJECTIVE: To assess three-dimensional (3D) changes of circummaxillary sutures following maxillary protraction with alternate rapid palatal expansions and constrictions (RPE/C) facemask protocol in maxillary retrusive children, and to investigate the relationship between the changes of circum-maxillary sutures and zygomaticomaxillary suture (ZMS) maturation, and to explore the factors of maxilla forward movement with RPE/C and facemask. METHODS: In the study (clinical trial registration No: ChiCTR2000034909), 36 maxillary retrusive patients were recruited and block randomized to either the rapid palatal expansion (RPE) group or the RPE/C group. Patients aged 7 to 13 years, Class Ⅲ malocclusion, anterior crossbite, ANB less than 0°, Wits appraisal less than -2 mm, and A-Np less than 0 mm were included in the study. The RPE group received rapid palatal expansion, whereas the RPE/C group received alternate rapid palatal expansions and constrictions, and both with facemask protraction. Head orientations of cone-beam computed tomography (CBCT) images were implemented by Dolphin 11.7. 3D measurements of circummaxillary sutures on CBCT images were evaluated using Mimics 10.01 before (T0) and after treatment (T1). The changes were analyzed with independent t test, two-way ANOVA, Pearson correlation and regression analysis. RESULTS: Two subjects in the RPE/C group were lost to follow-up. A total of 34 patients reached the completion criteria and were analyzed. Compared with the RPE group, sagittal changes of circummaxillary sutures were significantly increased in the RPE/C group with 1.21 mm advancement of zygomaticotemporal suture, 2.20 mm of ZMS, 1.43 mm of zygoma-ticofrontal suture (P < 0.05, respectively). Except for the zygomaticotemporal suture, the rest forward sagittal changes of other circummaxillary sutures showed no major difference in terms of the ZMS maturation. The Spearman's correlation in RPE/C indicated a strong positive correlation of sagittal changes between ZMS and point A (P < 0.01) with a regression analysis R²=42.5%. CONCLUSION RPE/C might be more effective on the treatment of maxillary retrusive children. As one of the major mechanical loading sutures during orthopedic therapy, ZMS showed a strong positive correlation with point A on sagittal changes.
Cone-Beam Computed Tomography/methods* ; Constriction ; Humans ; Malocclusion, Angle Class III/therapy* ; Maxilla/diagnostic imaging* ; Palatal Expansion Technique ; Sutures

OBJECTIVETo analyze the surgical patients treated with straight wire appliance for guidelines of clinical using of the appliance.

METHODSTotally 51 patients from Joint Clinic of Orthodontic Surgery, Peking University School of Stomatology with dentofacial deformities treated with straight wire appliance were analyzed. The patients were aged from 15 years to 34 years 5 months, average 18 years 9 months. Among whom, 16 are males, while the other 35 are females.

RESULTSEighteen patients were treated with extraction of teeth, while other 33 cases were nonextraction case. The duration of average presurgical orthodontic treatment was 13.3 months, and 10.4 months was for postsurgical orthodontic treatment, totally active treatment time was 25.5 months.

CONCLUSIONSStraight wire appliance would benefit a lot for three dimensional control of teeth when doing pre- and post-surgical orthodontic treatment. Good results could be achieved without wire bending.

Adolescent ; Adult ; Female ; Humans ; Male ; Malocclusion, Angle Class II ; therapy ; Malocclusion, Angle Class III ; therapy ; Orthodontic Wires ; Orthodontics, Corrective ; instrumentation ; methods ; Postoperative Care ; Preoperative Care ; Treatment Outcome ; Young Adult