Cephalometric changes after the correction of class III malocclusion with maxillary expansion/facemask therapy

The purpose of this study was to analyze the cephalometric changes that occurred during and after the correction of Class III malocclusion. The records of 24 Class III patients treated with a banded expansion appliance and custom facemask were compared with 24 Class I and 27 Class III untreated controls. Cephalometric means were calculated for the annualized data and compared univariately with unpaired t tests to determine significant differences. Treatment results showed more convexity of the facial profile from anterior displacement and downward and backward rotation of the maxilla and clockwise rotation of the mandible. The maxillary teeth moved forward while the lower incisors retruded. Postprotraction results showed the maxilla did not relapse after treatment but grew anteriorly similar to the Class III controls but less than the Class I controls. Mandibular growth was similar for the treatment and control groups. Dental changes compensated for decreasing overjet whereas the soft tissue profile showed no significant posttreatment changes. Results in the intercontrol comparison showed the Class III controls had significantly less forward movement of A-point and greater forward movement of the mandible than Class I controls. Because of these differences using a Class I control group to compare to a Class III treatment group will tend to underestimate the treatment effects and overestimate posttreatment changes. Overcorrection of the Class III malocclusion is recommended to compensate for postprotraction growth deficiency of the maxilla.