title: Treatments for adults with prominent lower front teeth.
abstract: BACKGROUND
  Prominent lower front teeth may be associated with a large or prognathic lower jaw (mandible) or a small or retrusive upper jaw (maxilla). Edward Angle, who may be considered the father of modern orthodontics, classified the malocclusion in this situation as Class III. The individual is described as having a negative or reverse overjet as the lower front teeth are more prominent than the upper front teeth.
  
  
  OBJECTIVE
  The purpose of this systematic review was to evaluate different treatments of Angle Class III malocclusion in adults.
  
  
  METHODS
  The following databases were searched: Cochrane Oral Health Group Trials Register (to 22 March 2012); CENTRAL (The Cochrane Library 2012, Issue 1); MEDLINE via OVID (1950 to 22 March 2012); EMBASE via OVID (1980 to 22 March 2012); LILACs (1982 to 22 March 2012); BBO (1986 to 22 March 2012); and SciELO (1997 to 22 March 2012).
  
  
  METHODS
  All randomized or quasi-randomized controlled trials of treatments for adults with an Angle Class III malocclusion were included.
  
  
  METHODS
  Three review authors independently assessed the eligibility of the identified reports. Two review authors independently extracted data and assessed the risk of bias in the included studies. The mean differences with 95% confidence intervals were calculated for continuous data.
  
  
  RESULTS
  Two randomized controlled trials were included in this review. There are different types of surgery for this type of malocclusion but only trials of mandible reduction surgery were identified. One trial compared intraoral vertical ramus osteotomy (IVRO) with sagittal split ramus osteotomy (SSRO) and the other trial compared vertical ramus osteotomy (VRO) with and without osteosynthesis. Neither trial found any difference between the two treatments. The trials did not provide adequate data for assessing effectiveness of the techniques described.
  
  
  CONCLUSIONS
  There is insufficient evidence from the two included trials, to conclude that one procedure is better or worse than another. The included trials compared different interventions and were at high risk of bias and therefore no implications for practice can be given. Further high quality randomized controlled trials with long term follow-up are required.
authors.affiliation: Neuro-Sono Sleep Center,Department of Neurology, Federal University of São Paulo, São Paulo - SP, Brazil. hmsugaya@gmail.com.
authors.forename: Hideko
authors.initials: H
authors.lastname: Minami-Sugaya
authors.forename: Débora A
authors.initials: DA
authors.lastname: Lentini-Oliveira
authors.forename: Fernando R
authors.initials: FR
authors.lastname: Carvalho
authors.forename: Marco Antonio C
authors.initials: MA
authors.lastname: Machado
authors.forename: Clóvis
authors.initials: C
authors.lastname: Marzola
authors.forename: Humberto
authors.initials: H
authors.lastname: Saconato
authors.forename: Gilmar F
authors.initials: GF
authors.lastname: Prado
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D008334:Mandible / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D014071:Tooth Abnormalities / Q000150:complications; D055815:Young Adult