Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances

Westwood, Patricia Vetlesen; McNamara, James A.; Baccetti, Tiziano; Franchi, Lorenzo; Sarver, David M.

doi:10.1067/mod.2003.44

Cited by 262 publications

(280 citation statements)

References 23 publications

(67 reference statements)

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“…No significant changes were recorded in the vertical skeletal or dental relationships. These short-term postpubertal treatment outcomes were similar to those reported by Westwood et al, 4 who implemented a comparable methodology of investigation.…”

Section: Discussionsupporting

confidence: 85%

“…26 When individual patient data were analyzed, we found that over 70% of the patients (16 of 22) could be considered clinically successful in the long term, whereas less than 30% of them (6 of 22) were unsuccessful at T3 because of relapse in the occlusal relationships. The prevalence rate for the long-term success of RME/ FM therapy of Class III malocclusion appears as a favorable result, and it is similar to the success rates reported in other studies on orthopedic Class III treatment that included a posttreatment interval (76% according to Westwood et al 4 ; 75% according to Ngan et al 9 and Wells et al 6 ; 67% according to H€ agg et al 5 ).…”

Section: Discussionsupporting

confidence: 84%

“…4,22 From T1 to T3, the treatment group did not show a significant amount of closure of the gonial angle (a growth modification that has been advocated as a favorable mechanism to limit linear increases of the mandible along Co-Gn 23 ) or any significant improvement in the sagittal position of the maxilla, as described by Westwood et al 4 and Pangrazio-Kulbersh et al 22 However, Franchi et al 7 showed that both of these craniofacial changes are induced by early, prepubertal orthopedic treatment of Class III disharmony, but they are not associated with later treatment, during or after puberty. Our study included patients who underwent orthopedic treatment before puberty (14 patients) and at puberty (8 patients).…”

Section: Discussionmentioning

confidence: 99%

“…First, a significant tendency for the reestablishment of the Class III growth pattern has been widely demonstrated after active protraction therapy, with special emphasis during the pubertal growth spurt. 4,[8][9][10] Second, pubertal growth tends to last longer in Class III subjects compared with Class I subjects. 11 On the other end, long-term observations at the end of active craniofacial growth are available for different orthopedic and orthodontic approaches: chincup therapy, with favorable short-term changes often not maintained at the end of growth, 12 and mandibular cervical headgear, with greater long-term stability of favorable mandibular modifications.…”

mentioning

confidence: 98%

“…1,2 The literature includes many articles on the short-term results of RME/FM therapy in growing subjects with Class III disharmonies, as described in a recent systematic review. 3 Several studies have also evaluated the outcomes of the orthopedic treatment protocol at postpubertal observations after fixed appliance therapy, either with 4 or without 5,6 untreated Class III controls. Both short-term and postpubertal observations indicated a fair-to-good effectiveness of RME/FM therapy, with about 70% to 80% of the patients showing favorable results after puberty.…”

mentioning

confidence: 99%

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Stability of rapid maxillary expansion and facemask therapy: A long-term controlled study

Masucci

Franchi

Defraia

et al. 2011

American Journal of Orthodontics and Dentofacial Orthopedics

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Introduction: The aim of this prospective controlled study was to evaluate the long-term effects of rapid maxillary expansion and facemask therapy in Class III subjects. Methods: Twenty-two subjects (9 boys, 13 girls; mean age, 9.2 years 6 1.6) with Class III disharmony were treated consecutively with rapid maxillary expansion and facemask therapy followed by fixed appliances. The patients were reevaluated at the end of the 2-phase treatment (mean age, 14.5 years 6 1.9) and then recalled about 8.5 years after the end of rapid maxillary expansion and facemask treatment (mean age, 18.7 years 6 2.1). Two groups of controls with untreated Class III malocclusion were used for statistical comparisons of the short-term and long-term intervals. Statistical comparisons were performed with the Mann-Whitney U test. Results: In the long term, no significant differences in maxillary changes were recorded, whereas the treatment group showed significantly smaller increases in mandibular protrusion. The sagittal maxillomandibular skeletal variables maintained significant improvements in the treatment group vs the control groups. Conclusions: In the long term, rapid maxillary expansion and facemask therapy led to successful outcomes in about 73% of the Class III patients. Favorable skeletal changes were mainly due to significant improvements in the sagittal position of the mandible. (Am J Orthod Dentofacial Orthop 2011;140:493-500)

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Section: Discussionsupporting

confidence: 85%