Prognostic approach to Class III malocclusion through case‐based reasoning

Abstract

Objective This investigation evaluates the evidence of case‐based reasoning (CBR) in providing additional information on the prediction of future Class III craniofacial growth. Settings and sample population The craniofacial characteristics of 104 untreated Class III subjects (7‐17 years of age), monitored with two lateral cephalograms obtained during the growth process, were evaluated. Materials and methods Data were compared with the skeletal characteristics of subjects who showed a high degree of skeletal imbalance (‘prototypes’) obtained from a large data set of 1263 Class III cross‐sectional subjects (7‐17 years of age). Results The degree of similarity of longitudinal subjects with the most unbalanced prototypes allowed the identification of subjects who would develop a subsequent unfavourable skeletal growth (accuracy: 81%). The angle between the palatal plane and the sella‐nasion line (PP‐SN angle) and the Wits appraisal were two additional craniofacial features involved in the early prediction of the adverse progression of the Class III skeletal imbalance. Conclusions Case‐based reasoning methodology, which uses a personalized inference method, may bring additional information to approximate the skeletal progression of Class III malocclusion.

Radiographic Imaging for the Diagnosis and Treatment of Patients with Skeletal Class III Malocclusion

“…In those cases, the Wits appraisal may work together with the ANB angle as they belong to different reference systems and need to be considered at the same time. For growing patients with skeletal Class III malocclusion, a smaller Wits appraisal was later identified as a negative predictor for the long-term success of treatment for Class III malocclusion, including face mask, chin-cup, headgear, and fixed appliance therapy [ 24 , 25 , 27 , 28 ]. However, the critical value of the Wits appraisal for orthopedic treatment outcome prediction remained unclear, due to the limitation of statistical models.…”

“…In addition, a longer distance of PH or a more inferior position of PNS was identified as a negative predictor for the growth pattern or the relapse of Class III malocclusion in children and adolescents ( Figure 2 b) [ 43 , 44 ]. In addition, the PP-SN angle describing the maxillary growth rotation was another predictor of the growth pattern or the relapse of Class III malocclusion in children, where a bigger angle would contribute to a more satisfactory prognosis ( Figure 2 a) [ 25 , 28 ]. In terms of decision-making, the maxillary dimension was recognized as a predictor for orthognathic surgery need among adult patients with Class III malocclusion based on the ML model, but the model does not provide detailed measurements [ 34 ].…”

Artificial intelligence and machine learning in orthodontics

“…28 Auconi et al applied case-based reasoning in predicting the progression of Class III malocclusion. 29 Di Carlo et al applied a network analysis to verify the possible association between the orthodontic features and upper airway characteristics and found the most closely connected features. 30 The decision on whether or not to perform extraction is one of the most debated issues in clinical orthodontics.…”

“…Lim et al developed comprehensive predictive models to determine prognostic factors and actually evaluated the need for orthognathic surgery (OGS) in mixed dentition patients using CL/P by AI systems 28 . Auconi et al applied case‐based reasoning in predicting the progression of Class III malocclusion 29 . Di Carlo et al applied a network analysis to verify the possible association between the orthodontic features and upper airway characteristics and found the most closely connected features 30 …”

Determination of treatment options for Class III malocclusions in adult patients based on cephalometric values: a systematic review

“…4 Recent studies have investigated the prognostic approach as a treatment decision tool in young Class III patients. [5][6][7] In adults, a treatment decision between orthodontic camouflage and orthognathic surgery for Class III malocclusion management has been a major challenge as the decision is complicated by many factors that need careful consideration.…”