The Effect of Chin-cup Therapy in Class III Malocclusion: A Systematic Review

Abstract

Background: The treatment of Class III malocclusion has been challenging for orthodontists. Among a plethora of treatment modalities, the chin-cup is considered a traditional appliance for early orthopedic intervention. Objective: The present study aims to investigate the current scientific evidence regarding the effectiveness of chin-cup therapy in Class III malocclusion of prognathic growing patients. Method: A systematic review of the literature was conducted using PubMed/Medline and the Cochrane Central Register of Controlled Trials from January 1954 to October 2015. Articles were selected based on established inclusion/ exclusion criteria. Results: The search strategy resulted in 3285 articles.14 studies were selected for the final analysis. They were all CCTs, 13 of retrospective and 1 of prospective design. Methodological quality was evaluated by a risk of bias assessment, as suggested by the Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies on Interventions. The reported evidence presented favorable short-term outcomes both in hard and soft tissues improving the Class III profile, as well as desirable dento-alveolar changes, positively affecting the Class III malocclusion. Conclusion: There is considerable agreement between studies that chin-cup therapy can be considered for the short-term treatment of growing patients with Class III malocclusion, as indicated by favorable changes both in the hard and soft tissues. The existence of considerable risk of bias in all selected studies and the unclear long-term effectiveness of chin-cup therapy highlight the need for further investigation to draw reliable conclusions.

Oral health related quality of life of patients with class III skeletal malocclusion before and after orthognathic surgery

“…The minimum sample size was calculated to be 66 patients ( n = 22 in each group) according to a study by Mousoulea et al, [3] assuming the standard deviation of the OHIP-14 score to be 4.62 and 6.08 in the control and monomaxillary groups, respectively, alpha = 0.05, and study power of 90%. To increase the reliability of the results, a minimum of 25 patients were evaluated in each group.…”

“…Clinically, class III malocclusion is defined as retrognathism of the maxilla or prognathism of the mandible or a combination of both. The prevalence of class III malocclusion is higher in Asian populations compared with Caucasians (23% versus 5%) [3]. Class III malocclusion is often associated with complex dentoalveolar problems including the edge to edge position of teeth or posterior cross-bite.…”

“…Class III malocclusion is often associated with complex dentoalveolar problems including the edge to edge position of teeth or posterior cross-bite. Class III patients mostly have esthetic problems, a concave profile and vertical functional pattern, which limits the function to vertical movements [3].…”

Developing Class III malocclusions: challenges and solutions

“…Recent systematic reviews showed that there is considerable agreement between studies in that chin cup therapy may be used for interceptive treatment of growing Class III malocclusion based on short-term favorable results. 113 , 114 …”

Posterior Mandibular Displacement—A Systematic Review Based on Animal Studies

“…Treatment in cases of extreme mandibular growth has been a challenge [ 6 , 7 ] and research has focused on the anatomy, histology and function of the TMJ [ 8 , 9 , 10 ] seeking the trigger of growth [ 11 ]. In experiments and in clinical practice, the mandible has been pushed backwards, mainly during the period of growth, for protrusion to alleviate [ 12 , 13 , 14 ]. Clinical observations of animal TMJs and the consequent suggestions after mandibular displacement have been heterogeneous and contradictory.…”