Korean J Orthod.  2009 Dec;39(6):362-371. 10.4041/kjod.2009.39.6.362.

Comparison of longitudinal treatment effects with facemask and chincup therapy followed by fixed orthodontic treatment on Class III malocclusion

• Lee NK
• Baek SH

• KMID: 1975780
• DOI: http://doi.org/10.4041/kjod.2009.39.6.362

Abstract

OBJECTIVE
The purpose of this study was to compare the longitudinal treatment effects of facemask with rapid maxillary expansion (FM/RME) and chincup (CC) therapy followed by fixed orthodontic treatment (FOT) in Class III malocclusion (CIII) patients. METHODS: The samples consisted of twenty-one CIII patients who had similar skeletal and dental characteristics before FM/RME or CC therapy and good retention results (Class I molar/canine relationship and positive overbite/overjet) after FOT (Group 1, FM/RME, n = 11; Group 2, CC, n = 10). Lateral cephalograms were taken before (T0) and after FM/RME or CC therapy (T1), and after FOT and retention (T2). Skeletal and dental variables were measured. Mann-Whitney U-test and Wilcoxon signed-rank test were used for statistical analysis. RESULTS: During T0-T1, FM/RME therapy induced forward movement of point A, and labioversion of the upper incisors. Both groups showed posterior repositioning of the mandible. FM/RME resulted in increase of the vertical dimension; however, CC caused an increase in articular angle and decrease in gonial angle. During T1-T2, both groups exhibited forward growth of point A. Group 1 showed forward growth and counterclockwise rotation of the mandible and increase of IMPA; however, Group 2, showed increase of ANS-Me/N-Me and decrease of overbite. CONCLUSIONS: The key factor for successful FM/RME and CC therapy and good retention results might be a harmonized forward growth of the maxilla that could keep pace with the growth and rotation of the mandible.

Keyword

Class III malocclusion; Facemask; Chin cup; Longitudinal evaluation

MeSH Terms

Humans
Incisor
Malocclusion
Mandible
Maxilla
Overbite
Palatal Expansion Technique
Retention (Psychology)

Reference

1. Campbell PM. The dilemma of Class III treatment. Early or late? Angle Orthod. 1983. 53:175–191.

2. Guyer EC, Ellis EE 3rd, McNamara JA Jr, Behrents RG. Components of class III malocclusion in juveniles and adolescents. Angle Orthod. 1986. 56:7–30.

3. McNamara JA. An orthopedic approach to the treatment of Class III malocclusion in young patients. J Clin Orthod. 1987. 21:598–608.

4. Ngan PW, Hagg U, Yiu C, Wei SH. Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction. Semin Orthod. 1997. 3:255–264.

5. Park HC, Lee JW. Study of horizontal skeletal pattern and dental arch in skeletal Class III malocclusion patients. Korean J Orthod. 2008. 38:358–369.

6. Turley PK. Orthopedic correction of Class III malocclusion with palatal expansion and custom protraction headgear. J Clin Orthod. 1988. 22:314–325.

7. Turley PK. Orthopedic correction of Class III malocclusion: retention and phase II therapy. J Clin Orthod. 1996. 30:313–324.

8. Arman A, Ufuk Toygar T, Abuhijleh E. Evaluation of maxillary protraction and fixed appliance therapy in Class III patients. Eur J Orthod. 2006. 28:383–392.

9. Baik HS. Clinical results of the maxillary protraction in Korean children. Am J Orthod Dentofacial Orthop. 1995. 108:583–592.

10. Chong YH, Ive JC, Artun J. Changes following the use of protraction headgear for early correction of Class III malocclusion. Angle Orthod. 1996. 66:351–362.

11. Shanker S, Ngan P, Wade D, Beck M, Yiu C, Hägg U, et al. Cephalometric A point changes during and after maxillary protraction and expansion. Am J Orthod Dentofacial Orthop. 1996. 110:423–430.

12. Kapust AJ, Sinclair PM, Turley PK. Cephalometric effects of face mask/expansion therapy in Class III children: a comparison of three age groups. Am J Orthod Dentofacial Orthop. 1998. 113:204–212.

13. Gallagher RW, Miranda F, Buschang PH. Maxillary protraction: treatment and posttreatment effects. Am J Orthod Dentofacial Orthop. 1998. 113:612–619.

14. Sung SJ, Baik HS. Assessment of skeletal and dental changes by maxillary protraction. Am J Orthod Dentofacial Orthop. 1998. 114:492–502.

15. Macdonald KE, Kapust AJ, Turley PK. Cephalometric changes after the correction of Class III malocclusion with maxillary expansion/facemask therapy. Am J Orthod Dentofacial Orthop. 1999. 116:13–24.

16. Arman A, Toygar TU, Abuhijleh E. Profile changes associated with different orthopedic treatment approaches in Class III malocclusions. Angle Orthod. 2004. 74:733–740.

17. Kama JD, Ozer T, Baran S. Orthodontic and orthopedic changes associated with treatment in subjects with Class III malocclusions. Eur J Orthod. 2006. 28:496–502.

18. Tortop T, Keykubat A, Yuksel S. Facemask therapy with and without expansion. Am J Orthod Dentofacial Orthop. 2007. 132:467–474.

19. Sakamoto T, Iwase I, Uka A, Nakamura S. A roentgenocephalometric study of skeletal changes during and after chin cup treatment. Am J Orthod. 1984. 85:341–350.

20. Sugawara J, Asano T, Endo N, Mitani H. Long-term effects of chincap therapy on skeletal profile in mandibular prognathism. Am J Orthod Dentofacial Orthop. 1990. 98:127–133.

21. Allen RA, Connolly IH, Richardson A. Early treatment of Class III incisor relationship using the chincap appliance. Eur J Orthod. 1993. 15:371–376.

22. Ishikawa H, Nakamura S, Kim C, Iwasaki H, Satoh Y, Yoshida S. Individual growth in Class III malocclusions and its relationship to the chin cap effects. Am J Orthod Dentofacial Orthop. 1998. 114:337–346.

23. Deguchi T, Kuroda T, Minoshima Y, Graber TM. Craniofacial features of patients with Class III abnormalities: growth-related changes and effects of short-term and long-term chincup therapy. Am J Orthod Dentofacial Orthop. 2002. 121:84–92.

24. Ko YI, Baek SH, Mah J, Yang WS. Determinants of successful chincup therapy in skeletal Class III malocclusion. Am J Orthod Dentofacial Orthop. 2004. 126:33–41.

25. Uner O, Yüksel S, Uçüncü N. Long-term evaluation after chincap treatment. Eur J Orthod. 1995. 17:135–141.

26. Ngan P, Yiu C, Hu A, Hägg U, Wei SH, Gunel E. Cephalometric and occlusal changes following maxillary expansion and protraction. Eur J Orthod. 1998. 20:237–254.

27. Westwood PV, McNamara JA Jr, Baccetti T, Franchi L, Sarver DM. Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances. Am J Orthod Dentofacial Orthop. 2003. 123:306–320.

28. Pangrazio-Kulbersh V, Berger JL, Janisse FN, Bayirli B. Long-term stability of Class III treatment: rapid palatal expansion and protraction facemask vs LeFort I maxillary advancement osteotomy. Am J Orthod Dentofacial Orthop. 2007. 131:7.e9–e19.

29. Uçüncü N, Uçem TT, Yüksel S. A comparison of chincap and maxillary protraction appliances in the treatment of skeletal Class III malocclusions. Eur J Orthod. 2000. 22:43–51.

30. Hwang CJ, Moon JL. A retrospective study on profile having favorable response to Facemask. Korean J Orthod. 1999. 29:147–156.

31. Mermigos J, Full CA, Andreasen G. Protraction of the maxillofacial complex. Am J Orthod Dentofacial Orthop. 1990. 98:47–55.

32. Merwin D, Ngan P, Hagg U, Yiu C, Wei SH. Timing for effective application of anteriorly directed orthopedic force to the maxilla. Am J Orthod Dentofacial Orthop. 1997. 112:292–299.

33. Ritucci R, Nanda R. The effect of chin cup therapy on the growth and development of the cranial base and midface. Am J Orthod Dentofacial Orthop. 1986. 90:475–483.

34. Hwang CI, Suhr CH. A roentgenocephalometric study on the effects of the chincap in the skeletal Class III malocclusion. Korean J Orthod. 1989. 19:219–244.

35. Chen KF, So LL. Sagittal skeletal and dental changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate. Angle Orthod. 1996. 66:363–372.

36. Mitani H, Sakamoto T. Chin cap force to a growing mandible. Long-term clinical reports. Angle Orthod. 1984. 54:93–122.

37. Wisth PJ, Tritrapunt A, Rygh P, Bøe OE, Norderval K. The effect of maxillary protraction on front occlusion and facial morphology. Acta Odontol Scand. 1987. 45:227–237.