Correction of Severe Class III Malocclusion by Mandibular Molar Distalization with Ramal Plates
Abstract
1. Introduction
2. Materials and Methods
2.1. Treatment Progress
2.2. Cephalometric Analysis
2.3. Dental Cast Analysis
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
- The ramal plates are effective in mandibular total retraction among adults.
- Severe Class III malocclusion can be successfully corrected without premolar extractions through the distalization of mandibular dentition. Thus, dental camouflage treatment with the ramal plates may offer a viable alternative to the orthognathic surgical approach in some patients.
- The ramal plate therapies provide effective vertical control in dentoskeletal dimensions.
- The skeletal anatomical boundaries of the retromolar region may limit the amount of mandibular molar retractions; however, the Class III correction of a full-cusp discrepancy through molar distalization was not hindered by such limitations.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Definitions |
---|---|
Frankfort Horizontal (FH) Plane | Plane extending from the most inferior point of the orbital margin to the external auditory meatus. |
Vertical Frankfort Horizontal (VFH) | Plane that is perpendicular to the Frankfort plane and passes through the most posterior point of the pterygomaxillary fissure. |
Mandibular Plane (MP) | Plane extending from the gonion to menton. |
Molar Crown (6C) to B | Distance from the first molar crown to the vertical Frankfort horizontal (VFH). |
Molar Root (6R) to B | Distance from the first molar root to the vertical Frankfort horizontal (VFH). |
Incisal Tip (1T) to B | Distance from the incisal tip to the vertical Frankfort horizontal (VFH). |
Incisal Root (1R) to B | Distance from the incisal root to the vertical Frankfort horizontal (VFH). |
Molar Crown (6C) to C | Distance from the first molar crown to the mandibular plane (MP). |
Molar Root (6R) to C | Distance from the first molar root to the mandibular plane (MP). |
Incisal Tip (1T) to C | Distance from the incisal tip to the mandibular plane (MP). |
Incisal Root (1R) to C | Distance from the incisal root to the mandibular plane (MP). |
Molar Long Axis/C (6/MP) Angle | Angle formed between the first molar long axis and mandibular plane (MP). |
Incisor Long Axis/C (1/MP) Angle | Angle formed between the incisor long axis and the mandibular plane (MP). |
Variables | Definitions |
---|---|
Arch Depth | Distance from the line between the most distal points of the first molars to the contact point formed by the central incisors. |
Intercanine Width | The distance between the canine cusp tips. |
1st Interpremolar Width | The distance between the first premolar buccal cusp tips. |
2nd Interpremolar Width | The distance between the second premolar buccal cusp tips. |
1st Intermolar Width | The distance between the mesiobuccal cusp tips of the first molars. |
Variables | Pretreatment | Post-Treatment | Treatment Effects | p |
---|---|---|---|---|
6C to VFH (mm) | 21.74 ± 3.88 | 18.09 ± 4.19 | −3.65 | 0.000 * |
6R to VFH (mm) | 19.45 ± 4.05 | 17.64 ± 3.94 | −1.81 | 0.000 * |
1C to VFH (mm) | 54.68 ± 2.81 | 51.36 ± 2.91 | −3.32 | 0.000 * |
1R to VFH (mm) | 47.62 ± 3.50 | 46.81 ± 3.68 | −0.81 | 0.002 * |
6C to MP (mm) | 25.57 ± 3.57 | 25.75 ± 3.46 | 0.18 | 0.367 |
6R to MP (mm) | 12.29 ± 2.91 | 12.97 ± 2.87 | 0.68 | 0.086 |
1C to MP (mm) | 41.25 ± 3.27 | 42.01 ± 4.27 | 0.76 | 0.123 |
1R to MP (mm) | 24.54 ± 2.74 | 25.78 ± 2.88 | 1.24 | 0.003 * |
L1-MP angle (°) | 83.88 ± 4.93 | 75.86 ± 4.65 | −8.02 | 0.000 * |
L6-MP angle (°) | 72.37 ± 8.03 | 66.01 ± 7.74 | −6.36 | 0.000 * |
Overjet (mm) | 0.19 ± 1.87 | 3.67 ± 0.96 | 3.48 | 0.000 *† |
Overbite (mm) | 0.68 ± 1.33 | 2.25 ± 0.91 | 1.57 | 0.000 *† |
Skeletal Variables | Pretreatment | Post-Treatment | Treatment Effects | p |
---|---|---|---|---|
SNA (°) | 82.14 ± 3.70 | 81.99 ± 3.73 | −0.15 | 0.419 |
SNB (°) | 83.21 ± 3.73 | 82.84 ± 3.54 | −0.37 | 0.114 † |
ANB (°) | −1.07 ± 2.30 | −0.66 ± 2.26 | 0.41 | 0.123 |
Wits appraisal (mm) | −7.06 ± 1.89 | −5.50 ± 2.29 | 1.56 | 0.000 * |
Pog to N perpendicular (mm) | 4.43 ± 5.71 | 4.40 ± 5.59 | −0.03 | 0.946 |
FMA (°) | 26.86 ± 6.79 | 27.03 ± 6.78 | 0.17 | 0.550 |
Facial height ratio (%) | 65.46 ± 5.12 | 65.68 ± 4.88 | 0.22 | 0.496 |
Soft tissue variables | ||||
Mentolabial angle (°) | 137.08 ± 9.51 | 139.21 ± 9.62 | 2.13 | 0.182 |
Upper lip E-plane (mm) | −2.21 ± 1.72 | −2.18 ± 1.51 | 0.03 | 0.989 † |
Lower lip E-plane (mm) | 1.73 ± 2.61 | 0.47 ± 2.15 | −1.26 | 0.003 *† |
Soft tissue Pog to VFH (mm) | 61.40 ± 6.01 | 60.55 ± 6.02 | −0.85 | 0.000 * |
Maxillary Arch Dimensions (mm) | Pretreatment | Post-Treatment | Treatment Effects | p |
Arch depth | 37.51 ± 2.90 | 37.84 ± 2.49 | 0.33 | 0.387 |
Intercanine width | 35.52 ± 1.90 | 37.17 ± 1.49 | 1.65 | 0.000 ** |
1st Interpremolar width | 44.01 ± 2.74 | 46.86 ± 1.45 | 2.85 | 0.000 ** |
2nd Interpremolar width | 50.64 ± 3.52 | 52.22 ± 1.64 | 1.58 | 0.044 * |
1st Intermolar width | 56.22 ± 3.41 | 56.05 ± 3.20 | −0.17 | 0.966 |
Mandibular Arch Dimensions (mm) | ||||
Arch depth | 34.17 ± 2.54 | 33.89 ± 1.83 | −0.28 | 0.227 |
Intercanine width | 27.75 ± 1.88 | 27.17 ± 1.73 | −0.58 | 0.110 |
1st Interpremolar width | 34.28 ± 2.93 | 37.21 ± 1.63 | 2.93 | 0.000 **† |
2nd Interpremolar width | 41.44 ± 3.49 | 43.92 ± 1.68 | 2.48 | 0.000 ** |
1st Intermolar width | 47.81 ± 3.05 | 48.75 ± 2.03 | 0.94 | 0.041 * |
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Almadih, A.; Chou, A.H.K.; Kook, Y.-A.; Mo, S.-S.; Han, S.H. Correction of Severe Class III Malocclusion by Mandibular Molar Distalization with Ramal Plates. Appl. Sci. 2024, 14, 11157. https://doi.org/10.3390/app142311157
Almadih A, Chou AHK, Kook Y-A, Mo S-S, Han SH. Correction of Severe Class III Malocclusion by Mandibular Molar Distalization with Ramal Plates. Applied Sciences. 2024; 14(23):11157. https://doi.org/10.3390/app142311157
Chicago/Turabian StyleAlmadih, Ahmed, Alex Hung Kuo Chou, Yoon-Ah Kook, Sung-Seo Mo, and Seong Ho Han. 2024. "Correction of Severe Class III Malocclusion by Mandibular Molar Distalization with Ramal Plates" Applied Sciences 14, no. 23: 11157. https://doi.org/10.3390/app142311157
APA StyleAlmadih, A., Chou, A. H. K., Kook, Y.-A., Mo, S.-S., & Han, S. H. (2024). Correction of Severe Class III Malocclusion by Mandibular Molar Distalization with Ramal Plates. Applied Sciences, 14(23), 11157. https://doi.org/10.3390/app142311157