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Dento-Skeletal and Upper Airways Effects of Class III Intermaxillary Elastics in Growing Patients: A Retrospective
Michele d'Attilio1, Gianluca Rosa1, Salvo Luca Gallo1
1Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.
Objective:
To evaluate the dento-skeletal and upper airway effects of a fully intraoral fixed appliance activated with Class III intermaxillary elastics in growing patients with skeletal Class III malocclusion, compared with an untreated matched control group.
Materials And Methods:
This retrospective controlled study included 18 growing patients treated with an intraoral appliance anchored to molar bands in both arches activated with intermaxillary elastics. An untreated control group of 18 subjects matched for skeletal disharmony, sex, chronological age, and observation interval was selected from the Burlington Growth Study (AAOF) database. Lateral cephalograms were obtained before (T0) and at the end of treatment (T1) and analyzed using the Steiner and Kirjavainen analyses. ANB and Wits appraisal were defined as primary outcomes.
Results:
No statistically significant baseline differences were found between groups. The study group showed a statistically significant improvement of the sagittal intermaxillary relationship as measured by the Wits appraisal (Δ = +4.60 mm), whereas the between-group difference in the ANB angle did not reach statistical significance (Δ = +0.59°). SNB remained essentially stable in the treated group (Δ = +0.01°) compared with a slight forward repositioning in controls (Δ = +0.78°). All vertical parameters showed no significant between-group differences. A non-significant trend toward upper incisor proclination was observed, while IMPA remained essentially stable (Δ = +1.58°). Airway changes were limited and topographically selective: significant increases were observed at the nasopharyngeal level and in soft palate length, with no significant changes at the velopharyngeal or oropharyngeal levels.
Conclusions:
The present study suggests that a fully intraoral fixed appliance activated with Class III intermaxillary elastics may represent a possible early treatment option in growing Class III patients. These preliminary findings should be confirmed by prospective controlled studies with larger samples, three-dimensional airway assessment and long-term follow-up.