Article Data

  • Views 3503
  • Dowloads 932

Original Research

Open Access

Treatment Classification of Class III Malocclusion

  • Robert J Kanas1,*,
  • Leonard Carapezza2
  • Scott J Kanas3

1Crittenton Medical Center, Rochester, Mi And Private Practice, Lakeville,Mi

2Tufts University School Of Dentistry, Boston, Ma And Private Practice Wayland, Ma

3University Of Detroit Mercy, Detroit, Mi

DOI: 10.17796/jcpd.33.2.431877341u182416 Vol.33,Issue 2,March 2009 pp.175-186

Published: 01 March 2009

*Corresponding Author(s): Robert J Kanas E-mail: robertkanas@sbcglobal.net

Abstract

Purpose: The purpose of this study was to identify Class III malocclusions within a pediatric practice that lend themselves to a more favorable treatment outcome at an earlier age (before 10 years) rather than initiating treatment at later adolescent growth stages and also to identify the degree of difficulty of the treatment of the Class III malocclusion.

Methods: Review of the current dental literature pertaining to the different clinical types of Class III malocclusions and their respective treatment protocols was performed. Various classification systems were studied and compared. A new treatment classification system of Class III malocclusions utilizing three dentoalveolar and three skeletal components combined with cephalometric information derived from commonly used cephalometric analyses was developed.

Results: Class III treatment types were conclusively identified: 1.) Early orthodontics only, 2.) Early combined orthodontics and orthopedics, 3.) Combined orthodontics and orthognathic surgery.

Conclusions: The conclusion supports Edward H. Angle's finding: "In studying a case of malocclusion, give no thought to the methods of treatment or appliances until the case shall have been classified and all peculiarities and variations from the normal type, occlusion and facial lines have been thoroughly comprehended. Then the requirements and proper plan of treatment becomes apparent."

Keywords

early treatment of malocclusion, class III, orthodontics, orthopedics, orthognathic surgery, protocols

Cite and Share

Robert J Kanas,Leonard Carapezza,Scott J Kanas. Treatment Classification of Class III Malocclusion. Journal of Clinical Pediatric Dentistry. 2009. 33(2);175-186.

References

1. Angle EH Treatment of malocclusion of the teeth and fractures of the maxillae. In: Angle system. 7th ed. Philadelphia: S.S. White manufacturing, 44–59, 1907.

2. Dewey M Classification of malocclusion. Int J Orthod, 1: 133–147, 1915.

3. Anderson GM. Practical orthodontics. 9th ed. St. Louis: C.V. Mosby, 1960: 144–150.

4. Proffit WR, Fields HW. Contemporary orthodontics 3rd ed. St. Louis: C. V. Mosby, 185–195, 2000.

5. Ackerman JL, Proffit WR. The characteristics of malocclusion: A mod-ern approach to classification and diagnosis. Am J Orthod, 56(5): 443–454, 1969.

6. Hellman M. Diagnosis in orthodontia and the method I use in practice. Angle Orthod, 13: 3–14, 1944.

7. Horowitz S, Hixon EH. The nature of orthodontic diagnosis. St Louis: The CV. Mosby Co., 1966.

8. Moyers RE Handbook of orthodontics. 4th ed. Chicago:Yearbook Med-ical Publishing Inc., 183–195, 1988.

9. Sanborn RT. Differences between the facial skeletal patterns of Class III malocclusion and normal occlusion. Angle Orthod, 25: 208–222, 1955.

10. Pascoe JJ, Hayward JR, Costich ER. Mandibular prognathism: Its eti-ology and a classification. J Oral Surgery, Anesth and Hosp Dent Serv, 18: 21–24, 1960.

11. Dietrich UC. Morphological variability of skeletal Class III relation-ships as revealed by cephalometric analysis. Trans Eur Orthod Soc, 131–140, 1970.

12. Jacobson AJ, Evans WG, Preston CB, Sadowsky PL. Mandibular prog-nathism. Am J Orthod, 66(2): 140–171, 1974.

13. Ellis EE, McNamara JA,Jr. Components of Adult Class III Malocclu-sion. J Oral Maxillofac Surg, 42: 295–305, 1984.

14. Ellis EE, McNamara JA, Jr. Components of adult Class III open bite malocclusion. Am J Orthod, 86(4): 277–290, 1984.

15. Guyer EC, Ellis EE, McNamara JA, Behrents RG. Components of Class III malocclusion in juveniles and adolescents. Angle Orthod, 56: 7–31, 1986.

16. Mouakeh M, Cephalometric evaluation of craniofacial pattern of Syr-ian children with Class III malocclusion. Am J Orthod Dentofac Orthop, 119: 640–649, 2001.

17. Jacobson AJ. The “Wits” appraisal of jaw disharmony. Am J Orthod, 67(2): 125–138, 1975.

18. McNamara JA, Jr. A method of cephalometric evaluation. Am J Orthod, 86(6): 449–469, 1984.

19. Steiner CC, Cephalometrics for you and me. Am J Orthod, 39: 729–755, 1953.

20. Steiner CC, Cephalometrics in clinical practice. Angle Orthod, 29: 8–29, 1959.

21. Petit H. Adaptations following accelerated facial mask therapy, in Clin-ical Alterations of the Growing Face, ed. J.A. McNamara,Jr, K.A. Ribbens, and R.P. Howe, Monograph 14, Crainiofacial Growth Series, Center for Human Growth and Development, University of Michigan, Ann Arbor, 1983.

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

23. McNamara JA, Jr., Brudon WL, Orthodontics and Dentofacial Ortho-pedics. Ann Arbor: Needham Press Inc., 85–95 and 487–517, 2001.

24. Regezi JA, Sciubba J Oral Pathology: Clinical Pathologic Correlations 2nd ed. Philadelphia: W.B. Saunders Co., 458–493, 1993.

25. Williams MD, Sarver DM, Sadowsky PL, Bradley E, Combined rapid maxillary expansion and protraction facemask in the treatment of Class III malocclusions in growing children: A prospective long-term study. Semin Orthod, 3(4): 265–274, 1997.

26. Ngan PW, Urban H, Yiu C, Wei SHY, Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction. Semin Orthod, 3(4): 255–264, 1997.

27. Nartallo-Turley PE, Turley PK, Cephalometric effects of combined palatal expansion and facemask therapy on Class III malocclusion. Angle Orthod, 68(3): 217–224, 1998.

28. Baccetti T, McG, McGill JS, Franchi L, McNamara JA, Jr, Tollaro I, Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofac Orthop, 113: 333–343, 1998.

29. Pangrazio-Kulbersh V, Berger J, Kersten G, Effects of protraction mechanics on the midface. Am J Orthod Dentofac Orthop, 114: 484–491, 1998.

30. Gallagher RW, Miranda F, Buschang PH, Maxillary protraction: Treat-ment and posttreatment effects. Am J Orthod Dentofac Orthop, 113: 612–619, 1998.

31. 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 Dentofac Orthop, 113: 204–212, 1998.

32. MacDonald KE, Kapust AJ, Turley PK, Cephalometric changes after the correction of Class III malocclusion with maxillary expansion/face-mask therapy. Am J Orthod Dentofac Orthop, 116: 13–24, 1999.

33. Baccetti T, Franchi L, McNamara JA,Jr, Treatment and posttreatment craniofacial changes after rapid maxillary expansion and facemask therapy. Am J Orthod Dentofac Orthop, 118: 404–413, 2000.

34. Saadia M, Torres E, Sagittal changes after maxillary protraction with expansion in Class III patients in the primary, mixed and late mixed dentitions: A longitudinal study. Am J Othod Dentofac Orthop, 117: 669–680, 2000.

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

36. Cha K-S, Skeletal changes of maxillary protraction in patients exhibit-ing skeletal Class III malocclusion: A comparison of three skeletal mat-uration groups. Angle Orthod, 73: 26–35, 2003.

37. Franchi L, Baccetti T, McNamara JA,Jr, Postpubertal assessment of treatment timing for maxillary expansion and protraction therapy fol-lowed by fixed appliances. Am J Orthod Dentofac Orthop, 126: 555–568, 2004.

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

39. Reyes BC, Baccetti T, McNamara JA, Jr, An estimate of craniofacial growth in Class III malocclusion. Angle Orthod, 76: 577–584, 2006.

40. Graber TM, Current orthodontic concepts and techniques. Philadel-phia: WB Saunders; 1969.

41. Brehm W, Carapezza LJ, Space age pedodontics: The use of the utility arch wire appliance. J Pedod, 11: 201–209, 1987.

42. Andrews LF. The straight-wire appliance. J Clin Orthod; 10 (Feb-Aug). 1976.

43. Beckwith JB. Macroglossia, omphalocele, adrenal cytomegaly, gigan-tism and hyperplastic visceromegaly. Birth Defects; 5: 188, 1969.

44. Escobar LF, Bixler D, Sadove M, Bull MJ,. Antley-Bixler syndrome from a prognostic perspective: report of a case and review of the liter-ature. Am J Med Genet, 29(4): 829–836, 1988.

45. Posnick JC, Ruiz RL, Tiwana PS, Craniofacial dysostosis syndromes: stages of reconstruction. Oral Maxillofac Surg Clin Am; Nov, 16(4): 475–491, 2004.

46. Katzen T, McCarthy JG, Syndromes involving craniosynostosis and midface hypoplasia. Otolary Clin North Am; 33(6): 1257–1284, 2000.

47. BinDayel NA, Ullbro C, Lokesh S, Al-Farra E, Cephalometric findings in patients with Papillon-Lefevre syndrome. Am J Orthod Dentofac Orthop, 134: 138–144, 2008.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 1.8 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top