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Effectiveness of interceptive treatment of class III malocclusions with skeletal anchorage: A systematic review and meta-analysis.

ABSTRACT: Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and were complemented by hand-searching. The criteria for eligibility were: patients who had undergone orthodontic treatment with skeletal anchorage (miniplates and miniscrews). Patients with syndromes or craniofacial deformities or who had undergone maxillofacial surgery were excluded. The following variables were recorded for each article: author, year of publication, type of study, sample size, dropouts, demographic variables, treatment carried out, radiographic study (2D or 3D), follow-up time, and quality of the articles on the Newcastle-Ottawa Scale. The means and confidence intervals of the following variables were employed: Wits, overjet, ANB, SNA and SNB. Initially, 239 articles were identified. After removing the duplicates and applying the selection criteria, 9 were included in the qualitative synthesis and 7 in the quantitative synthesis (meta-analysis). It may be concluded that skeletal anchorage is an effective treatment for improving skeletal Class III malocclusion, but when compared with other traditional treatments such as disjunction and face mask, there is no clear evidence that skeletal anchorage improves the results.

SUBMITTER: Rodriguez de Guzman-Barrera J

PROVIDER: S-EPMC5362089 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Effectiveness of interceptive treatment of class III malocclusions with skeletal anchorage: A systematic review and meta-analysis.

Rodríguez de Guzmán-Barrera Jorge J Sáez Martínez Carla C Boronat-Catalá Montserrat M Montiel-Company Jose María JM Paredes-Gallardo Vanessa V Gandía-Franco José Luís JL Almerich-Silla José Manuel JM Bellot-Arcís Carlos C

PloS one 20170322 3

Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and we ...[more]

PMID: 28328995

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Project description:OBJECTIVE:This Cross-sectional study used cone-beam computed tomography (CBCT) to evaluate the difference in the alveolar bone of the anterior teeth between high-angle adults with severe skeletal Class II malocclusions and Class III malocclusions. MATERIALS AND METHODS:The CBCT archives from 62 high-angle adults were selected from patients of the Stomatology Hospital of Peking University between October 2017 to January 2018. The 62 high-angle adult subjects were divided into the following 2 groups based on their sagittal jaw relationships: severe skeletal Class II and severe skeletal Class III. Vertical bone level (VBL), alveolar bone area (ABA), and thickness of alveolar bone were measured at 2 mm, 4 mm, and 6 mm below and above to the cemento-enamel junction (CEJ) level, as well as at the apical level. Then, independent samples t-test were conducted for statistical comparisons. RESULTS:In the maxillary incisors, the labial VBL was smaller in the patients in skeletal Class III group than those in skeletal Class II group (P<0.05). On the labial side, the ABA was significantly thinner in patients in skeletal Class II group than those in skeletal Class III group, especially in terms of the maxillary central incisors' ABA at 4 mm and 6 mm above the CEJ level (P<0.05), in terms of apical ABA and total ABA of the maxillary lateral incisors (P<0.05). The alveolar bone thickness around maxillary lateral incisors was significantly thinner in patients of skeletal Class II than that of patients of skeletal Class III, especially regarding the apical level on the labial side (P<0.05). The ABA of the mandibular alveolar bone in the area of the lower anterior teeth was significantly thinner in patients in skeletal Class III group than those in skeletal Class II group, especially in terms of apical ABA, total ABA on the labial and lingual sides, and ABA at 6 mm below the CEJ level on the lingual side (P<0.05). In the mandibular lateral incisors, the alveolar bone thickness was significantly thinner in patients in skeletal Class III group than it was in patients in skeletal Class II group, especially regarding the apical level on the lingual side (P<0.05). CONCLUSIONS:The ABA and the alveolar bone thickness of the mandibular anterior teeth were significantly thinner in the severe high-angle group of skeletal Class III adult patients than in the sample of severe high-angle skeletal Class II adult cases. Our study firstly revealed that the roots of the maxillary central and lateral incisors were placed more labially in the subjects of severe high-angle skeletal Class II than in those of severe high-angle skeletal Class III, especially in the lateral incisors.

Project description:BackgroundOrthognathic surgery can be carried out using isolated mandibular or maxillary movement and bimaxillary procedures. In cases of moderate skeletal malocclusion, camouflage treatment by premolar extraction is another treatment option. All these surgical procedures can have a different impact on the soft tissue profile.MethodsThe changes in the soft tissue profile of 187 patients (Class II: 53, Class III: 134) were investigated. The treatment approaches were differentiated as follows: Class II: mandible advancement (MnA), bimaxillary surgery (MxS/MnA), upper extraction (UpEX), or Class III: maxillary advancement (MxA), mandible setback (MnS), bimaxillary surgery (MxA/MnS), and lower extraction (LowEX) as well as the extent of skeletal deviation (moderate Wits appraisal: - 7 mm to 7 mm, pronounced: Wits <- 7 mm, > 7 mm, respectively). This resulted in five groups for Class II treatment and seven groups for Class III treatment.ResultsIn the Class II patients, a statistically significant difference (p ≤ 0.05) between UpEX and moderate MnA was found for facial profile (N'-Prn-Pog'), soft tissue profile (N'-Sn-Pog'), and mentolabial angle (Pog'-B'-Li). In the Class III patients, a statistically significant differences (p ≤ 0.05) occurred between LowEX and moderate MxA for facial profile (N'-Prn-Pog'), soft tissue profile (N'-Sn-Pog'), upper and lower lip distacne to esthetic line (Ls/Li-E-line), and lower lip length (Sto-Gn'). Only isolated significant differences (p < 0.05) were recognized between the moderate surgical Class II and III treatments as well between the pronounced Class III surgeries. No statistical differences were noticed between moderate and pronounced orthognathic surgery.ConclusionsWhen surgery is required, the influence of orthognathic surgical techniques on the profile seems to be less significant. However, it must be carefully considered if orthognathic or camouflage treatment should be done in moderate malocclusions as a moderate mandibular advancement in Class II therapy will straighten the soft tissue profile much more by increasing the facial and soft tissue profile angle and reducing the mentolabial angle than camouflage treatment. In contrast, moderate maxillary advancement in Class III therapy led to a significantly more convex facial and soft tissue profile by decreasing distances of the lips to the E-Line as well as the lower lip length.

Dataset Information

Effectiveness of interceptive treatment of class III malocclusions with skeletal anchorage: A systematic review and meta-analysis.

Publications

Effectiveness of interceptive treatment of class III malocclusions with skeletal anchorage: A systematic review and meta-analysis.

Similar Datasets

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