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Featured Application: The method of treatment described may be used in Class III patients, who reject orthognathic surgery. (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. [ABSTRACT FROM AUTHOR]

This study aimed to identify evidence from animal studies examining genetic variants underlying maxillomandibular discrepancies resulting in a skeletal Class III (SCIII) malocclusion phenotype. Following the Manual for Evidence Synthesis of the JBI and the PRISMA extension for scoping reviews, a participant, concept, context question was formulated and systematic searches were executed in the PubMed, Scopus, WOS, Scielo, Open Gray, and Mednar databases. Of the 779 identified studies, 13 met the selection criteria and were included in the data extraction. The SCIII malocclusion phenotype was described as mandibular prognathism in the Danio rerio, Dicentrarchus labrax, and Equus africanus asinus models; and as maxillary deficiency in the Felis silvestris catus, Canis familiaris, Salmo trutta, and Mus musculus models. The identified genetic variants highlight the significance of BMP and TGF‐β signaling. Their regulatory pathways and genetic interactions link them to cellular bone regulation events, particularly ossification regulation of postnatal cranial synchondroses. In conclusion, twenty genetic variants associated with the skeletal SCIII malocclusion phenotype were identified in animal models. Their interactions and regulatory pathways corroborate the role of these variants in bone growth, differentiation events, and ossification regulation of postnatal cranial synchondroses. Research Highlights: This study conducted a scoping review of animal studies to identify genetic variants that contribute to skeletal Class III malocclusion. Twenty genetic variants were linked to the skeletal Class III malocclusion phenotype in animal models, revealing an interconnected web of genetic interactions and regulatory pathways that demonstrate the significant roles of these variants in bone growth and differentiation, as well as the regulation of cranial synchondroses ossification during postnatal development. Key findings highlight the crucial roles of the BMP and TGF‐β signaling pathways, which are connected to bone development, differentiation, and the regulation of cranial synchondroses ossification during postnatal growth. [ABSTRACT FROM AUTHOR]

Background: The purpose of this clinical study was to assess the effects of different rapid maxillary expansion appliances on the severity of obstructive sleep apnea (OSA). Material and methods: Patients having a narrow maxilla and identified with OSA were divided randomly into three groups: tooth tissue-borne, tooth-borne, and bone-borne expanders. Changes in sleep parameters at baseline and 3-month follow-up detected by polygraphy were the primary outcome. Treatment of the crossbite was the secondary outcome. Dunn-Bonferroni tests, Kruskal–Wallis, and Wilcoxon analysis were applied for intra- and inter-group differences at p < 0.05 significance level. Results: Among 46 patients randomized, apnea-hypopnea index (AHI) changed from baseline to follow-up in all groups (− 1.6, p = 0.280; 0.6, p = 0.691; − 0.45, p = 0.796, respectively), with no between-group difference (p = 0.631). Oxygen desaturation index (ODI) altered from baseline to follow-up in all groups (0.80, p = 0.977; 0.20, p = 0.932; and − 1.00, p = 0.379, respectively), with no between-group difference (p = 0.858). There was no significant difference in minimum oxygen saturation from baseline to follow-up in all groups (0.00, p = 0.401; − 2.00, p = 0.887; 0.50, p = 0.407, respectively). No significant changes were observed in supine AHI from baseline to follow-up in all groups (0.00, p = 0.581; − 1.00, p = 0.393; 0.00, p = 0.972, respectively). The upper intermolar width increased from baseline to follow-up in all groups (5.04, p = 0.000; 3.15, p = 0.001; 5.41, p = 0.00, respectively) with no between-group difference (p = 0.560). Maxillary width increased from baseline to follow-up in all groups (4.25, p = 0.001; 4.74, p = 0.00; 4.49, p = 0.001, respectively) with no inter-group difference (p = 0.963). Conclusions: The amount of skeletal and dental expansion obtained in the maxilla was similar in all groups. Rapid maxillary expansion was not found to be effective in OSA treatment. Trial registration: ClinicalTrials.gov Identifier: NCT04604392. [ABSTRACT FROM AUTHOR]

Abstract Aims This study aimed to evaluate the short-term oropharyngeal airway volumetric changes in growing Class III maxillary-deficient patients treated by facemask without expansion compared with untreated Class III controls, using low-dose computed tomography. Methods Eighteen maxillary-deficient children (9 boys, nine girls) with a mean age of 7.81 ± 0.84 years were treated with maxillary bonded bite block and facemask (FM). Pre- (T1) and post-treatment (T2) low-dose CT images were acquired. Sixteen untreated Class III patients with a mean age of 7.03 ± 0.56 years had previously two low-dose CT scans within a one year of follow-up. Volumetric and minimal cross-sectional area measurements were obtained to assess the oropharyngeal airway changes. Quantitative mean, minimum, and maximum displacement of superimposed 3D models were estimated from a point-based analysis. Paired-samples t-tests were used for the intragroup comparisons, and an independent samples t-test and the Mann–Whitney U tests were carried out for the intergroup comparisons. Results A statistically significant increase in the total and retropalatal volumes oropharyngeal airway volume were observed in the control group (302.23 ± 345.58 and 145.73 ± 189.22 mm3, respectively). In the FM group, statistically significant increases in the total and retropalatal volumes were observed (738.86 ± 1109.37 mm3 and 388.63 ± 491.44 mm3, respectively). However, no statistically significant differences were found between the two groups, except for the maximum part analysis which was significantly greater in the FM group (p = 0.007). Conclusions FM therapy appeared to have no additional effects on the oropharyngeal airway other than those induced by growth.

Aims: This study aimed to evaluate the short-term oropharyngeal airway volumetric changes in growing Class III maxillary-deficient patients treated by facemask without expansion compared with untreated Class III controls, using low-dose computed tomography. Methods: Eighteen maxillary-deficient children (9 boys, nine girls) with a mean age of 7.81 ± 0.84 years were treated with maxillary bonded bite block and facemask (FM). Pre- (T1) and post-treatment (T2) low-dose CT images were acquired. Sixteen untreated Class III patients with a mean age of 7.03 ± 0.56 years had previously two low-dose CT scans within a one year of follow-up. Volumetric and minimal cross-sectional area measurements were obtained to assess the oropharyngeal airway changes. Quantitative mean, minimum, and maximum displacement of superimposed 3D models were estimated from a point-based analysis. Paired-samples t-tests were used for the intragroup comparisons, and an independent samples t-test and the Mann–Whitney U tests were carried out for the intergroup comparisons. Results: A statistically significant increase in the total and retropalatal volumes oropharyngeal airway volume were observed in the control group (302.23 ± 345.58 and 145.73 ± 189.22 mm3, respectively). In the FM group, statistically significant increases in the total and retropalatal volumes were observed (738.86 ± 1109.37 mm3 and 388.63 ± 491.44 mm3, respectively). However, no statistically significant differences were found between the two groups, except for the maximum part analysis which was significantly greater in the FM group (p = 0.007). Conclusions: FM therapy appeared to have no additional effects on the oropharyngeal airway other than those induced by growth. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: Maxillary deficiency, also called transverse deficiency of the maxilla, may be associated with posterior crossbite, as well as with other functional changes, particularly respiratory. In adult patients, because of bone maturation and the midpalatal suture fusion, rapid maxillary expansion has to be combined with a previous surgical procedure to release the areas of resistance of the maxilla. This procedure is known as surgically-assisted rapid maxillary expansion (SARME). Objective: This study discusses the indications, characteristics and effects of SARME, and presents a clinical case of transverse and sagittal skeletal maxillary discrepancy treated using SARME and orthodontic camouflage.

Bone-anchored maxillary protraction (BAMP) is an emerging treatment option for orthopedic correction of maxillary deficiency in young patients. Compared to reverse pull headgear (RPHG), it is believed that forces generated during BAMP result in greater circum-maxillary sutural separation, mandibular retrusion, and improved maxillary protraction. Mechanical loading of the circum-maxillary sutures during BAMP is still poorly understood. 20 ex-vivo pig heads were used. Miniplates and molar tubes were installed like clinical procedures. A series of five 200 ​g-force (gf) elastics were applied on the right and left side until 1000gf were reached. Strain gauges were installed across the zygomatico-maxillary (ZMS), zygomatico-temporal (ZTS), and nasofrontal suture (NFS). Differential variable reluctance transducers (DVRTs) were installed across the ZTS. Deformation of the sutures during BAMP and RPHG was measured and compared. Higher average sutural deformation of the ZTS and ZMS was seen in BAMP than RPHG: 36.6 ​± ​20.6με vs 18.0 ​± ​12.4με and 54.7 ​± ​28.5με vs 12.5 ​± ​14.8με, respectively. Similarly, higher NFS deformation was seen in BAMP (18.4 ​± ​12.9με vs. −0.8 ​± ​12.0με). DVRT data showed higher ZTS separation in BAMP than RPHG (6.3 ​± ​5.2 ​μm vs. 1.7 ​± ​2.1 ​μm). These differences were all statistically significant using the Wilcoxon-signed rank test. Both RPHG and BAMP forces separate the ZTS and ZMS. BAMP resulted in higher levels of sutural separation at the ZTS and ZMS by 2- and 5-fold, respectively. [ABSTRACT FROM AUTHOR]

Copyright of Clinical Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: One of the most common procedures done in orthodontics is the rapid maxillary expansion for the treatment of transverse maxillary deficiency. Hence, in the present study, we aim to evaluate the efficacy of the rapid palatal expansion assisted with the miniscrews. Materials and Methods: We piloted a prospective observational study among 50 age-matched adolescent participants. They were grouped equally to receive miniscrew and tooth-borne expanders. The alterations after 6 months of wearing the expanders were calculated for the root length variations of the premolars, tipping of the tooth, buccal bone thickness, and the transverse skeletal widths using the "cone-beam computed tomography" images. Comparison of the values was done between the groups using the Chi-square and ANOVA test, deliberating P < 0.05 as significant. Results: We observed significantly greater values for the miniscrew expander for all the four parameters than the tooth-borne device. However, there was no significant variation for the root lengths variations between the two groups. No tipping was noted for the miniscrew expander. Conclusions: The miniscrew palatal expander brought faster expansion of the palate than the conventional palatal expanders. The miniscrews were also safe with no adverse effects and were efficus. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this randomized trial study was to compare the effects of tongue plate and tongue appliance in the treatment of Class III malocclusion with maxillary deficiency in growing patients. Material and Methods 40 patients (19 males, 21 females) with maxillary deficiency were selected. 20 patients (9 boys, 11 girls) with the mean age of 9.3±1.2 were treated with tongue plate. 20 patients (10 boys, 10 girls) with the mean age of 10.1±0.7 were treated by tongue appliance. Lateral cephalograms obtained at the beginning and end of the study were analyzed. Results Paired t-tests and Wilcoxon test showed that SNA and ANB significantly increased in both groups. The Mann-Whitney test showed that there were no statistically significant differences between the two groups except for Jarabak ratio. Jarabak increased by 0.6±3.2° in the tongue appliance group and it decreased 0.4±1.6° in the tongue plate group (p<0.03). Conclusion Both treatment modalities were successful in moving the maxilla forward. The crib of the tongue appliance might bother the tongue and consequently parents are complaining about minor inflammation of the tongue. The smooth surface of the tongue plate might therefore confer some advantages to this system as compared to the tongue plate. [ABSTRACT FROM AUTHOR]

BACKGROUND: Skeletal class III malocclusion has been shown to involve the whole eranio-maxillofacial soft and hard tissues, and severe cases require orthodonti-orthognathic surgery treatment. The zygomaticomaxillary complex, as an important bone support in the middle of the face, affects the facial appearance. Therefore, the morphological characteristics of soft and hard tissues in this part should be taken as an important reference in the design of orthodontic or orthodonti-orthognathic surgery.OBJECTIVE: To measure the morphological differences of soft and hard tissues in the zygomaticomaxillary complex between skeletal class III malocclusion with maxillary deficiency patients and the normal control group by cone-beam CT multi-planner reconstruction technique.METHODS: Thirty patients with skeletal class III malocclusion and maxillary deficiency were selected as the trial group and 30 normal people as the control group. Cone-beam CT images of all subjects were collected, and the Mimics 19.0 software was used to reconstruct the original image. A total of six horizontal and sagittal planes, intersection points were determined to analyze the thickness of hard and soft tissues and angle of zygomaticomaxillary complex.RESULTS AND CONCLUSION:(1) The thickness of hard tissue at each measurement site on the surface of zygomaticomaxillary complex in the trial group was less than that in the normal control group(P < 0.05), and there was no significant difference in soft tissue thickness(P >0.05).(2) The measurement angles of sagittal maxillary angle, and sagittal zygomatic angle at S2, S3, and I1 in the trial group were smaller than those in the normal control group, but IMTA was larger than that in the normal control group(P < 0.05).(3) Compared with the normal control group, the development of the zygomaticomaxillary complex in the patients with skeletal class III malocclusion and maxillary deficiency was insufficient and zygomatic appearance was more flat. The difference in surface soft tissue thickness between the two groups was insignificant. Therefore, this difference should be considered in the preoperative diagnosis and analysis of orthodontics and orthodontics. [ABSTRACT FROM AUTHOR]

This is a report about the orthodontic treatment of a 13-year, 10-monthold boy with total ankyloglossia combined with a Class III occlusion. The patient's tongue was fixed to the floor of his mouth and could not be elevated at all. He had a maxillary deficiency and a mandibular protrusion with a negative overjet. However, he was able to retrude his mandible to an edge-to-edge position. Before orthodontic treatment, the ankyloglossia was surgically rectified. Orthodontic treatment was initiated to improve the patient's occlusion and facial appearance by correcting his retruded maxilla by means of a face mask, fixed appliances, and Class III elastics. This led to a functional occlusion and an acceptable facial appearance. [ABSTRACT FROM AUTHOR]

The aim of this article is to discuss an alternative treatment for adult patients who have a dental or skeletal Class III relationship. A 20-year-old woman presented with a dental and skeletal Class III relationship and a transverse maxillary deficiency. Surgically assisted rapid maxillary expansion was followed by maxillary protraction with a face mask and orthodontic treatment with standard edgewise technique. At the end of treatment, a Class I molar and canine relationship was attained with an adequate transverse intercuspation and improvement of the patient's facial profile. [ABSTRACT FROM AUTHOR]

Background and aim: Cleft lip and cleft palate are among the most common orofacial abnormalities. Patients with these deformities commonly present with midface deficiency and need challenging treatment modalities that focus on improving the position of the maxilla. Tongue plate appliance is an intraoral device that has shown promising results in the treatment of growing patients with maxillary deficiency. Nonetheless, the effects of tongue plate on patients with cleft lip and cleft palate have not been evaluated yet. This study aimed to assess the effects of tongue plate on growing patients with cleft lip and palate. Materials and methods: Twenty-four growing patients (12 girls and 12 boys) with non-syndromic unilateral cleft lip and cleft palate between the ages of 6-12 years volunteered to participate in this quasi-experiment. All the patients had undergone the preliminary stages of lip and palate closure during infancy, but none of them had received bone grafts. They were treated with tongue plate appliance for 18±3 months. Lateral cephalograms were obtained and were analyzed at the beginning and at the end of the treatment. Paired t-test was used for statistical analysis of normally-distributed data; otherwise, Wilcoxon test was used. Results: Paired t-test showed that the Sella-Nasion-Point A (SNA) angle was increased from 76.3±0.2 to 77.3±0.14 degrees, and the Point A-Nasion-Point B (ANB) angle was enhanced from -2.26±0.17 to 0.93±0.82 degrees (P

Objective: To determine the contribution of the nasal floor and hard palate morphology to nasal obstruction for nonresponders to prior intranasal surgery.Study Design: Retrospective case-control study.Setting: Tertiary academic center.Methods: Institutional review board-approved, retrospective institutional database analysis was obtained of a cohort of 575 patients who presented with nasal obstruction over a 21-year period. Of the patients, 89 met inclusion criteria: 52 were placed into the experimental group, defined as having persistent nasal obstruction following endoscopic sinus surgery (ESS), septoplasty, nasal valve repair, and/or turbinoplasty using validated subjective questionnaires, and 37 were placed into the control group, defined as having resolution of subjective nasal obstruction. Computed tomography imaging was presented to 3 blinded experts, who measured numerous nasal airway and hard palate morphology parameters, including anterior nasal floor width, anterior maxillary angle, maxilla width, anterior nasal floor width, and palatal vault height. Standard demographic information, comorbidities, perioperative 22-item Sinonasal Outcome Test (SNOT-22), and follow-up time were also assessed. Wilcox rank sum analysis or t test was performed where appropriate.Results: Follow-up ranged from 2 to 36 months following surgical intervention. Several skeletal characteristics within the upper airway were significantly associated with persistent nasal obstruction, including acute maxillary angle (P = .035), narrow maxillary width (P = .006), and high arched palate (P = .004).Conclusion: Persistent nasal obstruction may be seen in patients with narrow, high arched hard palate despite prior nasal surgical intervention and may benefit from additional skeletal remodeling procedures such as maxillary expansion. [ABSTRACT FROM AUTHOR]

Orthopedic correction of skeletal Class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Further, as surgery is done only at a later stage, early treatment helps to avoid the detrimental effects produced by the facial disfigurement on the patient's social life. This case report describes the treatment of a child aged 9 years 6 months who had a skeletal Class III malocclusion. The treatment plan involved the use of a reverse pull headgear (facemask) and multibracket appliance therapy resulting in successful correction of the malocclusion. The treatment results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar and canine relationship, an ideal overjet and overbite. Thus, dentoalveolar camouflage, if done in properly selected cases, alleviates the need for surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results.

Background and Objectives: Skeletal class III is a growth related discrepancy which continues and becomes more severe until active growth is completed. Approximately three percent of Indian population exhibits class III malocclusion. This can be due to a mid face deficiency, a large mandible or their combination. Various treatment modalities are available for correction of class III malocclusion in growing children, one of which is the Tandem Traction Bow Appliance (TTBA). This study was planned and designed to evaluate the dental and skeletal effects of TTBA used for the correction of skeletal Class III malocclusion with maxillary deficiency. Materials and Methods: An in-vivo study designed to study the effects of TTBA on class III malocclusion with maxillary deficiency. The study was carried out on ten patients (age 6-12 years). Pre and post lateral cephalograms were traced and analyzed. Paired t test was used to compare values. Result: The significant changes seen in the dental and skeletal parameters were upper and lower incisor retraction, Increase in ANB angulations and forward and downward movement of the maxillary arch. Conclusion: TTBA is effective in early treatment of Skeletal Class III malocclusion. Being intraoral, patient compliance is improved, thus making TTBA easier to use, both for the clinician as well as forthe patient. [ABSTRACT FROM AUTHOR]

Copyright of Hellenic Orthodontic Review is the property of Hellenic Orthodontic Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This report presents a case of a 12-year-old girl with maxillary deficiency, mandibular prognathism, and facial asymmetry, undergoing growth hormone (GH) therapy due to idiopathic short stature. Children of short stature with or without GH deficiency have a deviating craniofacial morphology with overall smaller dimensions; facial retrognathism, especially mandibular retrognathism; and increased facial convexity. However, a complete opposite craniofacial pattern was presented in our case of a skeletal Class III girl with idiopathic short stature. The orthodontic treatment goal was to inhibit or change the direction of mandibular growth and stimulate the maxillary growth of the girl during a course of GH therapy. Maxillary protraction and mandibular retraction were achieved using occipitomental anchorage (OMA) orthopedic appliance in the first stage of treatment. In the second stage, the patient was treated with a fixed orthodontic appliance using a modified multiple-loop edgewise archwire technique of asymmetric mechanics and an active retainer of vertical chin-cup. The treatment led to an acceptable facial profile and obvious facial asymmetry improvement. Class I dental occlusion and coincident dental midline were also achieved. A 3½-year follow-up of the girl at age 18 showed a stable result of the orthodontic and dentofacial orthopedic treatment. Our case shows that the OMA orthopedic appliance of maxillary protraction combined with mandibular retraction is effective for correcting skeletal Class III malocclusion with midface deficiency and mandibular prognathism in growing children with idiopathic short stature undergoing GH therapy.

The present report describes orthodontic treatment of a patient with skeletal Class III malocclusion and maxillary hypoplasia. To correct the retrusive maxilla, the treatment plan included an intra-oral removable device. It had the advantages of good patient cooperation, ease of construction and effective modification. Forward growth of the maxilla, minimal downward and backward rotation of the mandible and improved facial profile esthetics were achieved.

The following case report describes the management of a 6-year-old male patient in early mixed dentition with a mesial step molar relation, an anterior reverse overjet, and skeletal Class III due to a slightly deficient maxilla. The treatment plan included protraction of the maxilla by a reverse pull Petit type facemask for 10 months followed by 15 months of active retention by a Frankel III appliance.

"nBackground and Aim: Among different treatments of patients with Class III malocclusion , orthopedic protraction of maxilla has been known as an effective method in mixed dentition period. The aim of this study was to evaluate the cephalometric changes of Cl III patients in mixed dentition period following face mask therapy and slow maxillary expansion. "nMaterials and Methods: This was a before-after study which was conducted on 10 children in mixed dentition period, who had class III malocclusion and maxillary deficiency according to the Stiener and Mc Namara's analysis. The patients were all treated by protraction face mask and slow maxillary expansion. The cephalometric changes of maxilla , mandible and dental relations during the treatment were analyzed by Paired sample T Test. P

Midfacial deficiency is a common feature of cleft lip and palate patients due to scar tissue of the lip and palate closure procedure. The aim of this study was to evaluate the effectiveness of the physiological force of the tongue to move the maxilla in forward position. This research has been done experimentally by, before and after treatment following up in private practice. Ten patients (6 female, 4 male) with complete bilateral cleft lip and palate were selected. All of them had Cl III malocclusion with maxillary deficiency due to scar tissue of lip and palate surgery. Their age ranged from 7.6 to 9.8 years. All the patients were delivered tongue appliance to transfer the force of the tongue to maxillary complex. The mean observation time was 13±2 months to achieve positive overjet. Pre- and post-lateral cephalograms were compared to evaluate the skeletal changes with paired t-test. The results showed that after the application of tongue appliance, normal sagittal maxillomandibular relationship was achieved. SN-ANS angle was increased 1.9±1.8 - P < 0.05. Nasolabial angle was decreased 10.3±10.8 - P < 0.03. This study showed that the tongue appliance could transfer considerable force during rest and swallowing period to the maxilla. This method might be considered to improve the deficient maxilla by means of growth modification and redirect concept.

Objectives:The aim of this overview of systematic reviews was to investigate methodological quality and outcome of current systematic reviews (SRs) reporting on orthopaedic treatment for class III malocclusion. Materials and methods:Computerized and manual searches were performed in Medline, Google Scholar, Cochrane Library, Embase, LILACS, SciELO, American Journal of Orthodontics and Dentofacial Orthopaedics, Angle Orthodontist, European Journal of Orthodontics, Journal of Orthodontics, Conference abstracts and Grey literature. No restrictions were set on language or date of publication. The search covered the starting date of the relevant databases until 30 April 2015. MeSH terms and free-text terms included ‘malocclusion’, ‘Angle class III’, ‘orthodontic appliances’, ‘functional’, facemask, review and meta-analysis. Screening of eligible studies, assessment of the methodological quality of the SRs and data extraction were conducted in duplicate and independently by two reviewers. Methodological quality was assessed using AMSTAR (assessment of multiple systematic reviews). Results:A total of 222 studies were retrieved and after removal of duplicates, irrelevant studies, literature reviews and surgical approach treatments, 14 SRs and/or meta-analyses were included for qualitative synthesis. Mean AMSTAR score was 7.7/11 with a range of 3–10. There was evidence to demonstrate that face mask therapy can move the maxilla forward whilst causing a backward rotation of the mandible and increased facial height. There was also some evidence of mandibular growth retardation with chin cup therapy. Conclusions:Orthopaedic appliances can improve a class III malocclusion in growing patients over the short-term; however, each appliance has a characteristic effect on the underlying skeletal pattern. [ABSTRACT FROM PUBLISHER]

Orthopedic correction of skeletal Class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Further, as surgery is done only at a later stage, early treatment helps to avoid the detrimental effects produced by the facial disfigurement on the patient's social life. This case report describes the treatment of a child aged 9 years 6 months who had a skeletal Class III malocclusion. The treatment plan involved the use of a reverse pull headgear (facemask) and multibracket appliance therapy resulting in successful correction of the malocclusion. The treatment results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar and canine relationship, an ideal overjet and overbite. Thus, dentoalveolar camouflage, if done in properly selected cases, alleviates the need for surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study is to test the null hypotheses that there were no significant differences for hard and soft tissue changes induced by mini maxillary protractor (MMP) and face mask and rapid maxillary expansion (FM/RME). Materials and methods: Thirty-two patients who met the criteria were randomly divided into two groups: 16 patients (males/females 7/9) in the MMP group and 16 patients (males/females 6/10) in the FM/RME group. The patients in both groups were instructed to wear the appliances for at least 20 h per day until a 2-mm positive overjet was achieved. Hard and soft tissue profile changes observed by MMP and FM/RME were compared using paired and Student's t tests. Results: Class III malocclusion and negative overjet were improved by means of skeletal changes in conjunction with upper incisor proclination and lower incisor retroclination in both groups. Maxilla and surrounding soft tissues (SNA, Ls-E, and Ls-PMV) were significantly moved anteriorly with less rotation of the palatal plane in the MMP group. Mandibular incisors were found to be more retrusive in the FM/RME group ( p = 0.024). Conclusion: Both groups showed similar effects except more anterior movement of the maxilla and surrounding soft tissues with less rotation of the palatal plane and retrusion of lower incisors in the MMP group. Clinical relevance: This is the first study to compare the soft and hard tissue changes induced by MMP appliance with a conventional FM /RME. [ABSTRACT FROM AUTHOR]

Background and Objective: One of the dentoalveolar abnormalities is class III malocclusion with maxillary deficiency. Correction of this malocclusion in growth ages using orthopedic appliances to avoid further extensive surgical treatment and improvement in soft tissue profile will help to reach beauty. The objective of this study was to survey changes in soft tissue profile following tongue guard in class III patients with maxillary deficiency. Methods: In this experimental study, 20 class III patients (4 males and 16 females) with maxillary deficiency and reserve overjet with mean age of 7.5 years old referring to orthodontic department of Babol dental school in the year 2000 were treated by tongue guard at least for 6 months. 2 lateral cephalometry were obtained before and after treatment for each patient and after tracing results were compared. Findings: After cephalometric analyzing and comparison between before and after tracing, an obvious increase was found in forward movement of subnasal soft tissue (3.59mm), superior labial sulcus (3.12mm), incisal edge of centrals (3.38mm), upper lip prominence (4.53mm). Lower lip prominence (1.05mm), inferior labial sulcus (1.47 mm) and the most anterior point of chin (1.56mm) move anteriorly to some extent. Vertical distance of subnasal soft tissue (2.03 mm), superior labial sulcus (2.22mm), upper lip prominence (2.65mm), inferior labial sulcus (3.41mm), the most prominent point of chin (2.59mm) and incisal edge (3.47mm) have increased significantly. Nasolabial angle (-1.44°), mentolabial angle (1.82°) and soft tissue convexity angle (-2.36°) have decreased. Upper lip thickness decreased. Distance between upper lip and esthetic line decreased and distance between lower lip and E-line increased. Conclusion: Due to results of our study in class III patients with maxillary deficiency treated by tongue guard because of change in position of inferior hard tissue and teeth. We can expect an improvement in soft tissue profile due to movement of mid third of face forwardly and downward and backward rotation of mandible.