Maxillary response after facial orthopedic treatment in class III patients in early and late mixed dentition

Carceva Salja, Sofija and Papakoca, Kiro and Jusufi, Gazmend (2018) Maxillary response after facial orthopedic treatment in class III patients in early and late mixed dentition. In: Sofia Dental Meeting 2018, 27-30 Sept 2018, Sofia, Bulgaria.

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Skeletal Class III malocclusions are usually growth - related discrepancies, and these patients are well-recognized and perceived to be abnormal by the lay public as well as by health care practitioners. Concave facial profile is one of the most unattractive facial look who has negative impact to normal socializing of those individuals in the community. In many patients with Class III malocclusion the mandible appears large because of a deficient maxillary growth. With the limited ability to influence mandibular growth, treatment modalities for influencing mild to moderate Class III alveolar base discrepancies have shifted to a maxillary protraction therapy.
The purpose in this study was to determine sagittal behavior of the jaws and profile convexity changes in Class III growing patients in early(6-9years) and late(9-12 years) mixed dentition after maxilary protraction therapy.
Material and methods
The sample consisted 28 patients divided in two groups: early mixed dentition (6-9 years) and late mixed dentition (9-12years), who had Class III malocclusion with an anterior crossbite and a component of maxillary deficiency. The evaluation of the facial profile was one of the most important items in our differential diagnosis. Flat or concave profiles, retrusive maxillas, and prominent mandibles were included. The maxillary protraction was performed through a Delaire facial mask, using elastics with a force delivering of about 350 gm per side. In some patients with posterior cross bite, before proctacting maxilla, rapid maxillary expansion appliance was used, and it was activated every day until achiving corection of the bite posteriorly.
Two radiographs were evaluated, the first was taken before the beginning of the treatment, the second was taken immediately after face mask therapy. The treatment time varied as a result of patients compliance, severity of the problem and individual response of the patient to treatment. Treatment was discontinued when positive overjet was achieved and no more changes were noted after 3 months. Mean treatement time was 11 months.
Results from these study showed forward displacement of maxilla(SNA p<0.05),increasing of maxillary length (Co-A p<0.05) correction of maxillary-mandibular relationship (ANB p < 0.05) and soft tissue changes resulting in a more convex profile, mostly as a result of forward displacement of the maxilla. Skeletal response of the protraction treatment in upper jaw was highly significant in younger patients (early mixed dentition 6-9 years) while a smaller effect of treatment was obtained in older patients (late mixed dentition 9-12 years ).
The results from this study indicate that forward movement of maxilla can be obtained after Face mask therapy and better period for facial orthopedics is early mixed dentition rather than late mixed dentition.Based on our findings we can concluded that even though, the management of Class III malocclusion remains one of the most challenging problems in the clinical practice today, the results from this study support maxillary protraction, for the correction of Class III malocclusion with deficient maxillary growth which is very important in the teenage period of life for building self confidence and normal socializing in the community.

Item Type: Conference or Workshop Item (Poster)
Subjects: Medical and Health Sciences > Other medical sciences
Divisions: Faculty of Medical Science
Depositing User: Sandra Atanasova
Date Deposited: 07 Feb 2019 08:03
Last Modified: 02 Apr 2019 08:41

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