Three-dimensional soft tissue evaluation following different maxillary protraction in Class III patient

Area of Science:

• Orthodontics and Dentofacial Orthopedics
• 3D Imaging in Craniofacial Research
• Soft Tissue Analysis in Malocclusion

Background:

• Class III malocclusion presents challenges in soft tissue profile management.
• Maxillary protraction (MP) is a common treatment modality.
• Evaluating different expansion techniques combined with MP is crucial for optimizing outcomes.

Purpose of the Study:

• To compare the effects of three expansion methods (RPE, Alt-RAMEC, SA) combined with MP on the soft tissue profile.
• To analyze soft tissue changes using 3D stereophotogrammetry.
• To determine the most effective expansion technique for aesthetic soft tissue modification.

Main Methods:

• 51 patients (8-12 years) with Class III malocclusion were divided into three groups based on expansion technique.
• Treatment involved rapid palatal expansion (RPE), modified alternate rapid maxillary expansion and constriction (Alt-RAMEC), or skeletal anchorage (SA) with maxillary protraction (MP).
• Pre- and post-treatment soft tissue changes were assessed using 3D stereophotogrammetric images.

Main Results:

• All groups showed significant soft tissue changes, including increased midface, nasal, and upper lip volumes, and reduced lower lip and chin volumes.
• Skeletal anchorage (SA) group demonstrated the most significant increases in midface, nasal, and upper lip volumes.
• Rapid palatal expansion (RPE) showed the greatest alar base width increase, while SA led to the most nasal tip protrusion and upper lip reduction.

Conclusions:

• Skeletal anchorage (SA)-supported maxillary protraction (MP) provides superior control over soft tissue aesthetics.
• This method minimizes undesirable dental and vertical skeletal side effects compared to RPE and Alt-RAMEC.
• SA offers predictable and aesthetically pleasing soft tissue changes for Class III malocclusion treatment.