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19 pages, 1115 KiB  
Review
The Therapeutic Approaches Dealing with Malocclusion Type III—Narrative Review
by Zdenka Stojanovic, Nadica Đorđević, Marija Bubalo, Milos Stepovic, Nemanja Rancic, Miroslav Misovic, Milka Gardasevic, Maja Vulovic, Ivana Zivanovic Macuzic, Vesna Rosic, Nikola Vunjak, Simonida Delic, Kristijan Jovanovic, Melanija Tepavcevic, Ivona Marinkovic and Zlata Rajkovic Pavlovic
Life 2025, 15(6), 840; https://doi.org/10.3390/life15060840 - 22 May 2025
Viewed by 1249
Abstract
According to the World Health Organization, malocclusion type III is third, most important oral health problem. It may be the least prevalent malocclusion, but it is the most noticeable and challenging for orthodontic therapy. With this narrative review, we wanted to give a [...] Read more.
According to the World Health Organization, malocclusion type III is third, most important oral health problem. It may be the least prevalent malocclusion, but it is the most noticeable and challenging for orthodontic therapy. With this narrative review, we wanted to give a summation of the most current knowledge about diagnostics, different therapy options, limitations, and additional factors that can influence the therapy of class III malocclusion to help clinicians and researchers focus on the specific approaches. Therapy options were divided into the following groups: orthopedic, orthodontic, and surgical. The SNA, SNB, and ANB angles (cephalometric values) are the best ones to examine improvements in different skeletal improvements, while dentoalveolar improvements were also described, emphasizing the limitation of orthopedic therapy to change the skeletal discrepancy. Eruption-guided appliances and chin cups are more effective in early childhood, mixed dentition, during permanent teeth eruption, with no significant skeletal discrepancy. If a discrepancy exists, a face mask is the first therapy choice. The therapy of an underdeveloped maxilla can be solved with different palate expanders. Bulkiness, lack of long-term results, and duration of therapy make fixed orthodontic appliances with braces and elastic traction favorable nowadays. If the skeletal discrepancy is major, a surgical approach should be considered. One of the main limitations in articles is the combination of different therapy approaches, ages, and dentition preferred for device application, duration of therapy, and lack of information about long-term outcomes. On the other hand, the lack of original articles is noticeable, so further research should be done. Full article
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22 pages, 61878 KiB  
Article
Three-Stage Non-Surgical Treatment of Skeletal Class III Malocclusion in Adolescents—A Report of Four Cases with Long-Term Follow-Up
by Małgorzata Kuc-Michalska, Magdalena Pokucińska, Katarzyna Grocholewicz and Joanna Janiszewska-Olszowska
Appl. Sci. 2024, 14(17), 8095; https://doi.org/10.3390/app14178095 - 9 Sep 2024
Cited by 1 | Viewed by 4476
Abstract
(1) Background: Postponing orthodontic treatment in Class III malocclusion until deterioration and growth cessation to perform orthognathic surgery does not seem to be an optimal solution for every patient. This report describes short- and long-term outcomes for nonsurgical treatment of four adolescents with [...] Read more.
(1) Background: Postponing orthodontic treatment in Class III malocclusion until deterioration and growth cessation to perform orthognathic surgery does not seem to be an optimal solution for every patient. This report describes short- and long-term outcomes for nonsurgical treatment of four adolescents with severe Class III malocclusion. (2) Methods: Four patients (aged 13–15 y) with skeletal Class III (Wits appraisal below 7.5 mm) started a three-stage treatment, consisting of a six-month-long phase I and involving orthopedic treatment with an individual chin-cup. Phase II involved orthopedic treatment with a bonded Haas-type expander on acrylic splints, a face-mask, a lower fixed appliance and Class III elastics; phase III involved full fixed appliance, elastics and reuse of the individual chin-cup. Pre and posttreatment cephalograms were analyzed and superimposed. (3) Results: Improved skeletal and dental relationships and facial appearance was achieved in all patients. Wits appraisal, angles ANB, ANPg and lower face height increased; an improvement of overbite was noted. (4) Conclusions: Severe skeletal Class III in adolescents may be successfully treated with combined orthopedic/camouflage treatment with a Haas-type expander on acrylic splints, Class III elastics, fixed appliance and orthopedic devices (individual chin-cup and facemask) with a very good compliance. Full article
(This article belongs to the Section Applied Dentistry and Oral Sciences)
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11 pages, 3504 KiB  
Case Report
Customized Facial Orthopedics: Proof of Concept for Generating 3D-Printed Extra-Oral Appliance for Early Intervention in Class III Malocclusion
by Vincenzo Ronsivalle, Giorgio Gastaldi, Gianluigi Fiorillo, Alessandra Amato, Carla Loreto, Rosalia Leonardi and Antonino Lo Giudice
Prosthesis 2024, 6(1), 135-145; https://doi.org/10.3390/prosthesis6010011 - 1 Feb 2024
Cited by 3 | Viewed by 1466
Abstract
Background: The present case report serves as a proof of concept for the fabrication and effective clinical administration of a 3D-printed chin cup tailored to the patient’s anatomical characteristics. Methods: An 11-year-old male with a Class III malocclusion was treated using a chin [...] Read more.
Background: The present case report serves as a proof of concept for the fabrication and effective clinical administration of a 3D-printed chin cup tailored to the patient’s anatomical characteristics. Methods: An 11-year-old male with a Class III malocclusion was treated using a chin cup appliance to intercept and control a Class III mandibular skeletal growing pattern early. Two tailored chin cup devices were designed using 3D face scanning and CBCT scanning and were produced with additive manufacturing techniques. The chin pads were digitally designed based on a 3D scan of the patient’s face. The 3D modeling of chin cup components was performed using 3Shape Appliance Designer and 3D printed with biocompatible resin. An analogic chin pad was also produced for the same patient. The treatment plan involved the patient wearing the chin cup for 13 h per day. The patient was instructed to use all three chin pads produced at intervals of 4 months. The patient’s experience was assessed by reporting the comfort experience via a VAS scale. The treatment strategy was effective in improving the skeletal Class III malocclusion. Additionally, the integration of 3D face scanning (or CBCT scanning), modeling, and printing enables the production of customized chin cups with superior fit and comfort, contributing to enhanced patient compliance and treatment efficacy. Full article
(This article belongs to the Special Issue Digital Technologies, Materials and Telemedicine in Dentistry)
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16 pages, 669 KiB  
Review
Effect of Orthopedic Treatment for Class III Malocclusion on Upper Airways: A Systematic Review and Meta-Analysis
by Golnar Havakeshian, Vasiliki Koretsi, Theodore Eliades and Spyridon N. Papageorgiou
J. Clin. Med. 2020, 9(9), 3015; https://doi.org/10.3390/jcm9093015 - 18 Sep 2020
Cited by 18 | Viewed by 4131
Abstract
The aim of this systematic review is to compare the effect on the upper airways of orthopedic treatment for skeletal Class III malocclusion with untreated controls. Nine databases were searched up to August 2020 for randomized or nonrandomized clinical trials comparing orthopedic Class [...] Read more.
The aim of this systematic review is to compare the effect on the upper airways of orthopedic treatment for skeletal Class III malocclusion with untreated controls. Nine databases were searched up to August 2020 for randomized or nonrandomized clinical trials comparing orthopedic Class III treatment (facemask or chin-cup) to untreated Class III patients. After duplicate study selection, data extraction, and risk of bias assessment (Risk Of Bias In Non-randomized Studies-of Interventions [ROBINS-I]), random-effects meta-analyses of Mean Differences (MDs)/Standardized Mean Differences (SMD) and 95% Confidence Intervals (CIs) were performed, followed by the Grading of Recommendations Assessment, Development and Evaluation assessment evidence-quality. A total of 10 papers (9 unique nonrandomized studies) with 466 patients (42.7% male; average age 9.1 years) were finally included. Limited evidence indicated that compared to normal growth, maxillary protraction with facemask was associated with increases in total airway area (n = 1; MD = 222.9 mm2; 95% CI = 14.0–431.7 mm2), total nasopharyngeal area (n = 4; SMD = 1.6; 95% CI = 1.2–2.0), and individual airway dimensions (upper-airway MD = 2.5 mm; lower-airway MD = 2.1 mm; upper-pharynx MD = 1.6 mm; lower-pharynx MD = 1.0 mm; all n = 6). Subgroup/meta-regression analyses did not find any significant effect-modifiers, while the results were retained 2–5 years postretention. Our confidence in these estimates was, however, very low, due to the inclusion of nonrandomized studies with methodological issues. Limited data from 2 chin-cup studies indicated smaller benefits on airway dimensions. Existing evidence from controlled clinical studies on humans indicates that maxillary protraction for skeletal Class III treatment might be associated with increased airway dimensions, which are, however, mostly minor in magnitude. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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