Three-dimensional changes in the upper airway and craniomaxillofacial morphology of patients with Angle Class III malocclusion treated with a Frankel III appliance

Background Angle Class III malocclusion, characterized by a concave profile, can cause serious harm to children’s physical and mental health. The Frankel III appliance is an effective treatment for Angle Class III malocclusion in mixed denition. We explored three-dimensional changes in the upper airway and craniomaxillofacial morphology, after one year of Frankel III appliance treatment, in children with Angle Class III malocclusion. Methods We included 20 children (9 males), aged 8–10 years, with Angle Class III malocclusion from the Orthodontics Department of our hospital. Each child was treated with a Frankel III appliance for one year. Cone beam computed tomography was performed before and after treatment to evaluate three-dimensional changes in the upper airway and craniomaxillofacial morphology. Results After one year of treatment, in the upper airway, we observed significant increases in the nasopharynx volume and height (P < 0.05); the velopharyngeal volume, height, and average cross-sectional area (P < 0.05); the glossopharynx volume and minimum cross-sectional area (P < 0.05); and the laryngopharynx height (P < 0.05). Accordingly, the total upper airway volume, height, and average cross sectional area increased significantly (P < 0.05). An examination of craniomaxillofacial morphology showed significant increases in some bone tissues (P < 0.05) and dental measurements, and a significant reduction in the inclination of the mandibular central incisor (P < 0.05). Conclusion Children with Angle class III malocclusion treated with a Frankel III appliance showed no upper airway narrowing, even after repositioning the mandible posteriorly. Moreover, treatment promoted forward maxilla development and increased its width, in both the dental arch and alveolar bone, which provided a more harmonious craniofacial morphology.

Three-dimensional changes in the upper airway and craniomaxillofacial morphology of patients with Angle Class III malocclusion treated with a Frankel III appliance

Background Angle Class III malocclusion, characterized by a concave profile, can cause serious harm to children’s physical and mental health. The Frankel III appliance is an effective treatment for Angle Class III malocclusion in mixed denition. We explored three-dimensional changes in the upper airway and craniomaxillofacial morphology, after one year of Frankel III appliance treatment, in children with Angle Class III malocclusion. Methods We included 20 children (9 males), aged 8-10 years, with Angle Class III malocclusion from the Orthodontics Department of our hospital. Each child was treated with a Frankel III appliance for one year. Cone beam computed tomography was performed before and after treatment to evaluate three-dimensional changes in the upper airway and craniomaxillofacial morphology. Results After one year of treatment, in the upper airway, we observed significant increases in the nasopharynx volume and height (P<0.05); the velopharyngeal volume, height, and average cross-sectional area (P<0.05); the glossopharynx volume and minimum cross-sectional area (P<0.05); and the laryngopharynx height (P<0.05). Accordingly, the total upper airway volume, height, and average cross sectional area increased significantly (P<0.05). An examination of craniomaxillofacial morphology showed significant increases in some bone tissues (P<0.05) and dental measurements, and a significant reduction in the inclination of the mandibular central incisor (P<0.05). Conclusion Children with Angle class III malocclusion treated with a Frankel III appliance showed no upper airway narrowing, even after repositioning the mandible posteriorly. Moreover, treatment promoted forward maxilla development and increased its width, in both the dental arch and alveolar bone, which provided a more harmonious craniofacial morphology.

CBCT Evaluation in a Growing Patient With Mandibular Asymmetry Treated With Rapid Palatal Expander and Frankel-III. Case Report.

BackgroundThis study aims to evaluate the development and the compensation mechanisms of the mandibular asymmetry in a growing patient, using Cone Beam Computed Tomography (CBCT). In this case, the menton was deviated on the right, an extremely rare condition, which may be the consequence of a disorder in the mandibular growth. Case presentationThe patient was treated with Rapid Palatal Expander (RPE) and Fränkel Functional Regulator III (FR-3). The initial CBCT was acquired at the beginning of therapy, when patient was 8 years old (y.o), the final CBCT was acquired at the end of the treatment, when patient was 12 y.o. Patient’s CBCT was performed with the head oriented according to the Natural Head Position (NHP); the NHP is a physiological and reproducible posture defined for morphological analysis.The 3D image of the cranium was oriented in the Dolphin software according to NHP posture; the cephalometric measurements were performed in frontal, laterolateral right and left, posteroanterior and submentovertex views in the aforementioned software. The therapy lasted 3.8 years and ended with a significant regression of the mandibular asymmetry from moderate grade (4.2 mm) to slight grade (1.3 mm). Conclusion The left hemi-mandible has grown more than right side, in accordance with the literature, which affirm that in case of deviation of the menton greater than 4 mm, the bone volume increases on the nondeviated side.