Class III Malocclusion: A Cephalometric Study of Saudi Arabians

1989 ◽  
Vol 16 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Andrew P. Toms

The records of 500 consecutive Saudi Arabian patients referred for orthodontic treatment were examined clinically and cephalometrically for Class III malocclusion. A control group was drawn at random from the same sample. The incidence of Class III was 9·4 per cent, with mandibular prognathism being the commonest presentation of the malocclusion. The upper and lower incisors exhibited a marked degree of dentoalveolar compensation, on dental bases having mean values of SNA—78·77° and SNB—81·17°. The maxillary length was reduced, as were the saddle and maxillary—mandibular plane angles. The gonial angle (ArGoMe), anterior and posterior facial heights, and mandibular lengths (ArGo, ArPo) were all significantly larger than the control group. The cephalometric values of the control group showed the increased tendency to bimaxillary protrusion in the Saudi Arabian sample.

2017 ◽  
Vol 88 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Hee-Jong Kwak ◽  
Hae-Jin Park ◽  
Yoon-Ji Kim ◽  
Dong-Yul Lee

ABSTRACT Objectives: This study investigated the long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion and different vertical skeletal patterns. Materials and Methods: A total of 54 patients (20 boys and 34 girls; mean age, 7.7 ± 2.0 years) with Class III malocclusion who were successfully treated with facemask therapy were included in this study. Vertical skeletal changes (overbite depth indicator, angle between the Sella-Nasion (SN) plane and Gonion-Gnathion (GoGn) line, angle between the Frankfort horizontal (FH) plane and mandibular plane, gonial angle, and angle between the SN plane and palatal plane) were measured on lateral cephalograms from before treatment (T0) to after facemask therapy (T1) and from T0 to after retention (T2). Multivariate linear regression analysis was used to study the associations of the patients' skeletal patterns with the short-term (T0–T1) and long-term (T0–T2) vertical skeletal changes as a result of facemask therapy. Results: The mean treatment period of facemask therapy (T0–T1) was 1.4 ± 0.6 years, and the mean retention period (T1–T2) was 6.9 ± 2.6 years. Age at T0 was significantly correlated with vertical skeletal changes from T0 to T1. Differences in the treatment results between sexes were not significant. The angle between point A-point B line and mandibular plane to mandibular plane angle at T0 and the angle between the FH plane and mandibular plane at T0 were significant predictors for short-term and long-term changes. Changes in the Sella-Nasion-point A from T0 to T1 and from T1 to T2 significantly affected vertical changes in the short term and long term, respectively. Conclusions: Vertical skeletal changes as a result of facemask therapy are significantly associated with severity of the skeletal Class III malocclusion and mandibular plane angulation before treatment and the amount of forward maxillary growth during the treatment and retention periods.


2019 ◽  
Vol 42 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Roberto Martina ◽  
Vincenzo D’Antò ◽  
Vittoria De Simone ◽  
Angela Galeotti ◽  
Roberto Rongo ◽  
...  

Summary Objective To evaluate dental and skeletal effects of a new orthopaedic appliance for the treatment of Class III malocclusion in growing patients. Material and methods This retrospective cephalometric study was performed on a sample of 18 patients with a skeletal Class III malocclusion (4 males; 14 females; mean age 8.8 ± 1.5 years) treated with the Pushing Splints 3 (PS3) protocol. The control group consisted of 18 subjects (5 males; 13 females; mean age 9.1 ± 1.8 years) selected from a database of subjects with untreated Class III malocclusion. The cephalometric analysis was performed at the beginning (T0) and the end of the orthopaedic therapy (T1). Significant differences between the treated and control groups were assessed with independent samples t-test (P < 0.05). Results In the PS3 group, the post-treatment cephalometric values showed a forward displacement of the maxilla, resulting in a statistically significant increase of the SNA angle. ANPg and Wits appraisal improved significantly compared with the control group. Lingual inclination of mandibular incisors and buccal inclination of the upper incisors were significantly increased in comparison with the control group. No significant differences were recorded for backward mandibular rotation. Limitations This study presents a short-term evaluation of the treatment and the use of a historical control group. Conclusions The PS3 was effective for the treatment of Class III malocclusion in growing patients, with favourable maxillary advancement and control of the vertical skeletal relationships.


2021 ◽  
Vol 10 (4) ◽  
pp. 750
Author(s):  
Ralph M. Steegman ◽  
Annemarlien Faye Klein Meulekamp ◽  
Arjan Dieters ◽  
Johan Jansma ◽  
Wicher J. van der Meer ◽  
...  

This prospective controlled trial aimed to evaluate the skeletal effect of 3.5-years bone anchored maxillary protraction (BAMP) in growing cleft subjects with a Class III malocclusion. Subjects and Method: Nineteen cleft patients (11.4 ± 0.7-years) were included from whom cone beam computed tomography (CBCT) scans were taken before the start of BAMP (T0), 1.5-years after (T1) and 3.5 y after (T2). Seventeen age- and malocclusion-matched, untreated cleft subjects with cephalograms available at T0 and T2 served as the control group. Three dimensional skeletal changes were measured qualitatively and quantitatively on CBCT scans. Two dimensional measurements were made on cephalograms. Results: Significant positive effects have been observed on the zygomaticomaxillary complex. Specifically, the A-point showed a displacement of 2.7 mm ± 0.9 mm from T0 to T2 (p < 0.05). A displacement of 3.8 mm ± 1.2 mm was observed in the zygoma regions (p < 0.05). On the cephalograms significant differences at T2 were observed between the BAMP and the control subjects in Wits, gonial angle, and overjet (p < 0.05), all in favor of the treatment of Class III malocclusion. The changes taking place in the two consecutive periods (ΔT1-T0, ΔT2-T1) did not differ, indicating that not only were the positive results from the first 1.5-years maintained, but continuous orthopedic effects were also achieved in the following 2-years. Conclusions: In conclusion, findings from the present prospective study with a 3.5-years follow-up provide the first evidence to support BAMP as an effective and reliable treatment option for growing cleft subjects with mild to moderate Class III malocclusion up to 15-years old.


Author(s):  
Anjana Atteeri ◽  
Praveen Kumar Neela ◽  
Pavan Kumar Mamillapalli ◽  
Vasu M. Sesham ◽  
Sreekanth Keesara ◽  
...  

Abstract Background Mandibular prognathism (MP) is a craniofacial deformity resulting from the combined effects of environmental and genetic factors. Although various linkage and genome-wide association studies for mandibular prognathism have identified multiple strongly associated regions and genes, the causal genes and variants responsible for the deformity remained ambiguous. Aim This research work was aimed to study the association between polymorphism rs10850110 of the MYO1H gene and skeletal class-III malocclusion in our local population. Materials and Methods Thirty patients with skeletal class III due to mandibular prognathism in the study group and 30 patients with skeletal class I in the control group were selected for this study. These patients were from both sexes and above age 10 years. Based on the cephalometric values, patients were categorized into study and control groups. SNB (angle between sella, nasion and point B at nasion) greater than 82 degrees with an ANB (angle between point A, nasion and point B at nasion) of less than 0 degrees in the study group and ANB (angle between point A, nasion and point B at nasion) of 2 to 4 degrees in the control group were categorized. The polymorphism (rs10850110) of the MYO1H gene was genotyped using polymerase chain reaction and restriction fragment length polymorphism. Associations were tested with SNP exact test using SNPstats software. Results The single-nucleotide polymorphism rs10850110 showed a statistically significant association with mandibular prognathism. The G allele of marker rs10850110 (5′ of myosin1H - MYO1H) was overrepresented when compared with the “A” allele in mandibular prognathism cases (p < 0.0001), and this was very significant. Conclusion These results suggest that the rs10850110 polymorphism of the MYO1H gene is associated with an increased risk for mandibular prognathism.


2021 ◽  
Vol 11 (6) ◽  
pp. 2520
Author(s):  
Andrea Deregibus ◽  
Simone Parrini ◽  
Maria Chiara Domini ◽  
Jacopo Colombini ◽  
Tommaso Castroflorio

Many studies report that maxillofacial growth is influenced by genetic and environmental elements and that incorrect breathing, chewing, sucking, and swallowing are promoting factors of malocclusion. This study aims to evaluate the function and the influence of the tongue positions in patients with Angle class III malocclusion, maxillary hypoplasia, and posterior crossbite. One hundred patients, aged between 6 and 12 years old, were enrolled for the study. In the first group, patients with a diagnosis of class III malocclusion, affected by maxillary hypoplasia, skeletal class III, and posterior dental crossbite were recruited. In the control group, not treated patients with no malocclusion, skeletal class I, and without posterior dental crossbite were selected. Regarding atypical deglutition, no statistical differences were reported between the two groups, and 14% of patients reported ankyloglossia. Statistical differences were found in tongue rest position and during the execution of “hold and pull” and “chuck” exercises. Results obtained in this observational study showed that the clinician (orthodontist or general dentist) should analyze the presence/absence of atypical swallowing, the anatomical and functional aspects, and the tongue behavior in the rest position.


2013 ◽  
Vol 18 (1) ◽  
pp. 94-102 ◽  
Author(s):  
Luís Fernando Castaldi Tocci ◽  
Omar Gabriel da Silva Filho ◽  
Acácio Fuziy ◽  
José Roberto Pereira Lauris

INTRODUCTION: This retrospective cephalometric study analyzed the influence of intentional ankylosis of deciduous canines in patients with Class III malocclusion and anterior crossbite, in the deciduous and early mixed dentition stages, treated by orthopedic maxillary expansion followed by maxillary protraction. METHODS: Lateral cephalograms of 40 patients were used, divided in 2 groups paired for age and gender. The Ankylosis Group was composed of 20 patients (10 boys and 10 girls) treated with induced ankylosis and presenting initial and final mean ages of 7 years 4 months and 8 years 3 months, respectively, with a mean period of maxillary protraction of 11 months. The Control Group comprised 20 patients (10 boys and 10 girls) treated without induced ankylosis, with initial and final mean ages of 7 years 8 months and 8 years 7 months, respectively, with a mean period of maxillary protraction of 11 months. Two-way analysis of variance and covariance analysis were applied to compare the initial and final cephalometric variables and the treatment changes between groups. RESULTS: According to the results, the variables evidencing the significant treatment changes between groups confirmed that the intentional ankylosis enhanced the sagittal response of the apical bases (Pg-NPerp) and increased the facial convexity angles (NAP and ANB). CONCLUSIONS: The protocol involving intentional ankylosis of deciduous canines enhanced the sagittal response of the apical bases.


2017 ◽  
Vol 54 (5) ◽  
pp. 502-508 ◽  
Author(s):  
Trindade-Suedam Ivy Kiemle ◽  
Freire Lima Thiago ◽  
Dominguez Campos Letícia ◽  
Faria Yaedú Renato Yassutaka ◽  
Filho Hugo Nary ◽  
...  

Objective The objective of this study was to three-dimensionally evaluate the pharyngeal dimensions of individuals with complete nonsyndromic unilateral cleft lip and palate (UCLP) using cone beam computed tomography. Design This was a cross-sectional prospective study. Setting The study took place at the Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil. Patients and Participants The control group (CON) consisted of 23 noncleft adults with class III malocclusion, and the cleft group (UCLP) consisted of 22 individuals with UCLP and class III malocclusion. Two subgroups of individuals with class III malocclusion as a result of maxillary retrusion with (UCLP'; n = 19) and without (CON'; n = 8) clefts were also assessed. Interventions Pharyngeal volume, pharyngeal minimal cross-sectional area (CSA), location of CSA, pharyngeal length, sella-nasion-A point angle (SNA), sella-nasion-B point angle (SNB), and A point-nasion-B point angle (ANB), and body mass index were assessed using Dolphin software. Main Outcome Measure The pharyngeal dimensions of UCLP individuals are smaller when compared with controls. Results Mean pharyngeal volume (standard deviation) for the UCLP patients (20.8 [3.9] cm3) and the UCLP’ patients (20.3 [3.9] cm3) were significantly decreased when compared with the CON (28.2 [10.0] cm3) and CON’ patients (29.1 [10.2] cm3), respectively. No differences were found in the pharyngeal minimal CSA, ANB, or pharyngeal length values between groups (CON versus UCLP and CON’ versus UCLP'). CSAs were located mostly at the oropharynx, except in the UCLP’ patients, which were mainly at the hypopharynx. Mean SNA in the UCLP (76.4° [4.6°]) and UCLP’ groups (75.1 [3.1°]) were significantly smaller than those in the CON (82.8° [4.1°]) and CON’ groups (78.6° [1.2°]). SNB values were statistically smaller only for the comparison of CON versus UCLP patients. Conclusion The pharynx of individuals with UCLP and class III malocclusion is volumetrically smaller than that of individuals with class III malocclusion and no clefts.


2021 ◽  
Vol 10 (32) ◽  
pp. 2543-2547
Author(s):  
Rashmi Jawalekar ◽  
Pushpa Hazare ◽  
Ranjit H. Kamble ◽  
Vikrant V. Jadhav

BACKGROUND Facial prognathism may be because of prognathic maxilla, prognathic mandible or aggregate of both. Numerous studies performed to diagnose a single morphological feature commonly producing protrusive relationship, revealed that ‘a single morphological feature does not ordinarily produce a protrusive relationship. Existence of structural imbalance in one area also affects the nature of balance in other areas. A number of separate but inter-related cause and effect factors tend to augment each other in a cumulative and composite manner. Effect of marked discrepancy of an individual’s facial part could be cancelled or nullified by deviation of another part in opposite direction, ultimately resulting in good facial harmony. In this study by means of cephalometric roentgenography, the relation between Angle SNA and Angle NSAr was assessed in Vidharbhites, having normal occlusion, Class II division I and class III malocclusion. METHODS 40 individuals of normal occlusion, Class II division I and Class III Malocclusion, each between 16 and 25 years were analysed. These subjects were selected from patients reporting the outpatient department of Government Dental College, Nagpur. Statistically correlation between angles SNA and NSAr at level of significance 5 % was assessed. RESULTS After data collection a thorough observation & analysis was done and co-relation coefficient between SNA angle & NSAr (F--1.054 M--0.7981), also standard deviation of angular cephalometric measurement between males & females was found out in the population, leading to discussion on topic ‘Facial prognathism is due to maxillary prognathism, mandibular prognathism or combination of both’. In Females SNA was found to be 81 - 800 1.91310 and in males SNA was 82.1660 4. 380 respectively. CONCLUSIONS The results inferred that “Marked part of variation in Angle SNA can be explained by variation in Angle NSAr. KEY WORDS Angle SNA, Angle NSAr, Correlation


Author(s):  
MSA Mamun ◽  
MLA Hyder ◽  
MZ Hossain

Objective: This longitudinal retrospective cephalometric study was undertaken in an attempt to evaluate the effect of Class III activator on the soft tissue structures in subjects with skeletal Class III. Methods: The material consisted of cephalometric films of 26 Class III patients (13females and 13 males, with a mean age of 13.58±4.38 years). Each treated patient was matched before treatment with Class III subject for sex and age. Differences at T1 and T2 were examined using paired t-test. Results: After treatment the patients' soft tissue profile improved significantly compare with before treatment. Conclusion: Soft tissue changes were found in patients treated by Class III activator in skeletal Class III patients. Clinical relevance: Class III activator may be an efficient method to improving soft tissue facial profile in Skeletal Class III malocclusion. DOI: http://dx.doi.org/10.3329/bjodfo.v2i2.16160 Ban J Orthod & Dentofac Orthop, April 2012; Vol-2, No.2, 24-29


2019 ◽  
Vol 31 (4) ◽  
pp. 883-888
Author(s):  
Sofija Carceva Shalja ◽  
Sandra Atanasova

Developing Class III Malocclusion in most of the cases affects dentofacial appearance. The goal of this study is to investigate the changes in the facial appearances in treated patients withFace mask orthopedic treatment and untreated Class III patients. The sample consisted 49 patients (boys and girls),with average age of 9 years, who had a Class III Malocclusion with an anterior crossbite and a component of maxillary deficiency. 28 of them were treated with protraction Face mask- Delair mask (petit tipe), and the other 21 were presenting the control group consisted of untreated Class III Patients.In treated group pretreatment and posttreatment cephalometric radiographs from 28 patients(15 males and 13 females) were analyzed and compared with the results of cephalometric analyzes in untreated group(observation period of 1 year). Results from these study showed forward displacement of maxilla(SNA p<0.05),increasing of maxillary length(Co-A p<0.05)correction of maxillary-mandibular relationship(ANB p<0.05) in treated group while in untreated groupvalues for the parameters in the upper jaw and inter jaw relationship before and after the observation period of 1 yearshowed no statistically significant changes pointing to the negative impact of incorrect skeletal terms in Class III growing patients.Based on our findings we can concluded that in Class III patients there is a big motivation for orthodontic treatment because their dentofacial appearance deviates from sociocultural norms.Therefore, an important objective of accepting maxillary protraction treatment in Class III malocclusion is providing nonsurgical alternative in the treatment and improving the physico-social wellbeing and appearance of the patients, especially during their teenage years.


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