Early class III protraction facemask treatment reduces the need for orthognathic surgery: a multi-centre, two-arm parallel randomized, controlled trial
نویسندگان
چکیده
OBJECTIVE To evaluate whether patients who had received early class III protraction facemask treatment were less likely to need orthognathic surgery compared with untreated controls. This paper is a 6-year follow-up of a previous clinical trial. DESIGN Multi-centre 2-arm parallel randomized controlled trial. SETTING Eight United Kingdom hospital orthodontic departments. PARTICIPANTS Seventy three 7- to 9-year-old children. METHOD Patients were randomly allocated, stratified for gender, into an early class III protraction facemask group (PFG) (n = 35) and a control/no treatment group (CG) (n = 38). The primary outcome, need for orthognathic surgery was assessed by panel consensus. Secondary outcomes were changed in skeletal pattern, overjet, Peer Assessment Rating (PAR), self-esteem and the oral aesthetic impact of malocclusion. The data were compared between baseline (DC1) and 6-year follow-up (DC4). A per-protocol analysis was carried out with n = 32 in the CG and n = 33 in the PFG. RESULTS Thirty six percent of the PFG needed orthognathic surgery, compared with 66% of the CG (P = 0.027). The odds of needing surgery was 3.5 times more likely when protraction facemask treatment was not used (odds ratio = 3.34 95% CI 1.21-9.24). The PFG exhibited a clockwise rotation and the CG an anti-clockwise rotation in the maxilla (regression coefficient 8.24 (SE 0.75); 95% CI 6.73-9.75; P < 0.001) and the mandible (regression coefficient 6.72 (SE 0.73); 95% CI 5.27-8.18; P < 0.001). Sixty eight per cent of the PFG maintained a positive overjet at 6-year follow-up. There were no statistically significant differences between the PFG and CG for skeletal/occlusal improvement, self-esteem or oral aesthetic impact. CONCLUSIONS Early class III protraction facemask treatment reduces the need for orthognathic surgery. However, this effect cannot be explained by the maintenance of skeletal cephalometric change.
منابع مشابه
Expansion/Facemask Treatment of an Adult Class III Malocclusion
The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reporte...
متن کاملIs early Class III protraction facemask treatment effective? A multicentre, randomized, controlled trial: 15-month follow-up.
OBJECTIVE To investigate the effectiveness of early class III protraction facemask treatment in children under 10 years of age. DESIGN Multicentre, randomized controlled trial. SETTING Eight UK hospital orthodontic units. SUBJECTS AND METHODS Seventy-three patients were randomly allocated, stratified for gender, into an early class III protraction facemask group (PFG) (n = 35) and a contr...
متن کاملEarly Treatment of Class III Patients To Improve Facial Aesthetics and Predict Future Growth
The objective of this study is to determine the profile changes in Class III patients treated with protraction facemask and propose the use of serial cephalometric radiographs and a Growth Treatment Response Vector (GTRV) analysis to predict excessive mandibular growth. Serial cephalometric radiograph of 40 Class III patients who were treated with protraction facemask were included in the study...
متن کاملManaging the developing Class III malocclusion with palatal expansion and facemask therapy.
One of the most significant changes in the area of early treatment in recent decades concerns managing the developing Class III malocclusion. Twenty-five years ago, early intervention for Class III malocclusion was not common in the United States. Management usually involved chincup appliances to restrain mandibular growth, camouflage techniques to advance maxillary incisors and retract mandibu...
متن کاملEfficacy of orthopedic treatment with protraction facemask on skeletal Class III malocclusion: a systematic review and meta-analysis.
The objective of this systematic review was to estimate the efficacy of protraction facemask on the correction of Class III malocclusion in the short term. A systematic review of articles was performed using different electronic databases (PubMed, Ovid, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, and Google Scholar). Search terms comprised 'orthopedic treatment' and ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 43 شماره
صفحات -
تاریخ انتشار 2016