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Soft tissue paradigm based Treatment planning in skeletal class III
YoungCheol Kim1, Seung Il Song2, Sung Hyo Lee1
1Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, South Korea.
Clinical Oral Investigations
|November 26, 2024
Summary
Orthodontic treatment for skeletal Class III malocclusion shows that while surgery yields significant skeletal changes, both non-extraction and extraction camouflage treatments offer distinct soft tissue improvements, guiding treatment selection.
Area of Science:
- Orthodontics and Dentofacial Orthopedics
- Cephalometric Analysis
- Skeletal Malocclusion Treatment
Background:
- Skeletal Class III malocclusion (ANB < 0°) presents challenges in achieving optimal facial aesthetics.
- Treatment decisions involve balancing hard tissue correction with soft tissue outcomes.
- Evaluating soft tissue changes, such as the nasolabial angle (CKHA), is crucial for treatment success.
Purpose of the Study:
- To compare the soft tissue improvement effects of non-extraction, extraction camouflage, and orthognathic surgery in skeletal Class III malocclusion.
- To propose guidelines for treatment selection based on soft tissue response.
- To correlate hard tissue changes (ANB) with soft tissue changes (CKHA).
Main Methods:
- Retrospective cephalometric analysis of 66 patients with skeletal Class III malocclusion.
- Patients were divided into three groups: non-extraction (G1), extraction (G2), and orthognathic surgery (G3).
- Lateral cephalometric radiographs before and after treatment were analyzed to compare changes in ANB and CKHA.
Main Results:
- Significant differences in ANB were found between non-extraction (G1) and extraction/surgery (G2/G3) groups.
- No significant differences in CKHA were observed across the three treatment groups post-treatment.
- In the extraction group (G2), CKHA approached normal values (-1.8°), indicating potential soft tissue normalization with minimal skeletal change.
Conclusions:
- Orthognathic surgery provides the most substantial skeletal correction.
- Both non-extraction and extraction camouflage treatments offer significant advantages in soft tissue outcomes.
- Extraction camouflage (G2) demonstrated posterior lower lip movement and soft tissue B point shift, contributing to improved aesthetics.
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