EFFECT OF FACIAL ORTHOPEDIC TREATMENT IN CLASS III PATIENTS AT DIFFERENT AGE

Abstract

Having in mind the fact that modern smile doesn’t mean only well alaigned teeth but an “attractive smile” incorporated in one balanced face with regular position of all cranio-facial structures, facial otrhopedics becomes a very often treatment option in skeletal anomalies. These anomalies in most cases are geneticall and are connected with irregular growth of cranio facial structures. The treatment of Class III Malocclusion with skeletal pathern in growing patients it’s directed to growth modification therapy after wich goes the second phase of the treatment with fixed orthodontic appliance.
To give our contribution in context of this issue, we have set the following goal- to determine the effect after growth modification therapy with facial mask in pseudo class III patients at different age by determining the antero-posterior maxillary changes, maxillo-mandibular relationship and profile convexity changes in early and late mixed dentition.
The sample consisted of 28 patients (13 on 6-9 years of age and 15 on 9-12 years of age) who had a pseudo-Class III malocclusion. They were treated with Delair face mask and hyrax appliance for rapid maxillary expansion (where transversal maxillary deficit was present.) Average treatment time was 13 months. Changes after facial orthopedic treatment were detected by using lateral cephalograms before and after the treatment.
Cephalometric analysis after the treatment showed, anterior displacement of maxilla detected trhough statistically significant changes (p<0,05) of the length of upper jaw Co-A and for SNA angle in Class III patients. Examined parameters for inter-jaw relationship, ANB angle(p<0.05), Wits appraisal and parameters for profile convexity – NPg-A и NsSnPgs angle, in early and late mixed dentition, after the maxillary protraction treatment showed significant changes or more precisely correction of maxilla-mandibular relationship with straightening the concave profile in treated patients which were more emphasized in the early mixed dentition.
The more significant changes in treated patients from 6-9 years compared to those from 9-12 years old, contain important clinical message. Clinical doctors can more decisively approach in treating young patients with moderate class III malocclusion through interceptive orthopedic treatment.
Treating the patients earlier or right after the diagnostics of the anomaly, with mild hypercorrection, can provide conditions for normal growth of the craniofacial complex which will have positive effect on the further growth of the upper and lower jaw, as well as on the patients overall psychophysical development.