Class III Malocclusion—The Evidence on Diagnosis and Treatment

Ghafari, Joseph G.; Haddad, Ramzi; Saadeh, Maria

doi:10.1002/9781118688489.ch16

Cited by 4 publications

(5 citation statements)

References 47 publications

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“…The measurements used to define the groups were different from those used to assess other pertinent characteristic measures. Regardless of the method used for stratifying the four groups in gradation from flatness through fullness, the cephalometric measurements revealed the following: flat groups were characterized by a higher position of sella and posteriorly tipped-up palatal plane, features found in Class III malocclusion, which in turn has been associated with maxillary retrognathism and presumed associated midface flatness (Ghafari, Haddad & Saadeh, 2011). In addition, the midface position was not related to the length of the maxilla as ANS–PNS was similar across all groups.…”

Section: Discussionmentioning

confidence: 99%

“…flat groups were characterized by a higher position of sella and posteriorly tipped-up palatal plane, features found in Class III malocclusion, which in turn has been associated with maxillary retrognathism and presumed associated midface flatness (Ghafari, Haddad & Saadeh, 2011). In addition, the midface position was not related to the length of the maxilla as ANS–PNS was similar across all groups.…”

Section: Discussionmentioning

confidence: 99%

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Differentiation between maxillary and malar midface position within the facial profile

Chalala

Ghafari

2019

PeerJ

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AimsTo define midfacial position differentiating maxillary and zygomatic regions and to evaluate the corresponding cephalometric characteristics discerning midfacial flatness and fullness.Material and MethodsA total of 183 pretreatment lateral cephalometric radiographs of non-growing orthodontic patients (age 25.98 ± 8.43 years) screened at our university orthodontic clinic. The lateral cephalographs of the orthodontic patients were stratified in four groups: flat, normal toward flat, normal toward full, full,according to distances from nasion and sella to points J and G (NJ, SJ, NG and SG). J is the midpoint of the distance connecting orbitale to point A, and G the center of the triangle connecting orbit, key ridge and pterygomaxillary fissure. Statistics included the Kendall tau-b test for best associations among measurements.ResultsAll measurements were statistically significantly different between flat and full groups. The highest associations were between NJ and SJ (τb = 0.71; p < 0.001) and NG and SG (τb = 0.70; p < 0.001). Flat midfaces were characterized by canting of the cranial base and palatal plane, hyperdivergent pattern and maxillary retrognathism. The opposite was true for fuller midfaces.ConclusionMidface skeletal location was assessed differentially in the naso-maxillary and malo-zygomatic structures differentially. Craniofacial characteristics were identified according to this stratification, indicating the potential for application in facial diagnosis and need for testing on 3D cone-beam computed tomography images.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Differentiation between maxillary and malar midface position within the facial profile

Chalala

Ghafari

2019

PeerJ

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“…Orthognathic surgery was avoided at the expense of a long treatment because appliances were kept beyond a late-occurring adolescent growth spurt. (Adapted with permission from Ghafari et al 19 ) branded medically necessary. However, the label is usually dropped when a lisp is associated with an open bite or a Class III malocclusion.…”

Section: Vital Functions: Speech and Masticationmentioning

confidence: 99%

“…Further mandibular growth, unbalanced by concomitant growth of a maxilla growing at a comparatively slower rate, coupled with the inaccuracy of mandibular growth forecasting, requires the orthodontist to anticipate the growth spurt to minimize its effect (e.g., favoring maxillary growth or mandibular rotation to counteract additional mandibular growth). 19 Often, early treatment combines maxillary expansion and facemask and aims at overcorrection, that is, increase of overjet, which results from both the maxillary protraction (with a side effect of counterclockwise rotation) and mandibular clockwise rotation. Barring excessive mandibular growth that may steer treatment toward later orthognathic surgery, the interaction between overjet overcorrection and mandibular growth defines success through one of these possibilities (Fig.…”

Section: Growth Mattersmentioning

confidence: 99%

“Medically necessary” orthodontic care: Challenges and applications

Ghafari

2016

Seminars in Orthodontics

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“…19 Nevertheless, Classes I and III differed in MCA values (P ¼ .016), this angle being smaller in Class III than in Class I malocclusions, indicating a relatively more prominent pogonion in Class III malocclusions. Further research should investigate differences in T-line and mandibular length between these malocclusions.…”

Section: Angular Measurements In the Chin-throat Zonementioning

confidence: 99%

Chin-throat anatomy: Normal relations and changes following orthognathic surgery and growth modification

Haddad

Ghafari

2017

The Angle Orthodontist

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Objectives: To determine if a new facial line (T), tangent to the throat, intersects the mandibular border in anterior (ANT) and posterior (POST) parts in proportions varying with facial configuration, and to evaluate the association between chin projection and throat inclination and the potential for the T-line to reflect this association. Materials and Methods: Measurements on profile photographs and cephalograms of 135 adults (aged 18-50 years)-45 each of Class I, II, and III (CI, CII, CIII) malocclusions-included ANT and POST, chin-throat (CTA), and mento-cervical (MCA) angles. Pre-and posttreatment measurements were compared in two subgroups (n ¼ 25 each) of CII and CIII orthognathic surgery patients and in CII, division 1 early-treatment patients (n ¼ 63). Statistics included analysis of variance and ttest for group differences, and Pearson correlation for associations among variables. Results: ANT was nearly equal to POST in CI (50.99%) and CIII (51.86%) subjects and shorter in CII (36.01%) subjects. CTA and MCA were greater in CII profiles and smaller in CIII profiles. Significant differences (P , .0001) were observed for ANT, POST, CTA, and MCA between Classes I/II and II/III and for MCA between Classes II/III (P ¼ .016). High correlations were noted between ANT and CTA in Classes I (r ¼À0.83), II (r ¼À0.73), and III (r ¼À0.68). In surgically treated patients, posttreatment measurements approached CI values. In the early-treatment group, ANT increased but remained smaller than POST; CTA decreased by nearly 13%. Conclusions: Chin-throat relations and chin extension are associated and require routine assessment in terms of diagnosis and treatment outcome. A practical tool to assess chin-throat relationship, the T-line bisects the mandibular body nearly equally in Class I faces. (Angle Orthod. 2017;87:696-702.)

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Class III Malocclusion—The Evidence on Diagnosis and Treatment

Cited by 4 publications

References 47 publications

Differentiation between maxillary and malar midface position within the facial profile

Differentiation between maxillary and malar midface position within the facial profile

“Medically necessary” orthodontic care: Challenges and applications

Chin-throat anatomy: Normal relations and changes following orthognathic surgery and growth modification

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