Long-term skeletal and dental effects of facemask versus chincup treatment in Class III patients : A retrospective study.
OBJECTIVE
To investigate the skeletal and dental changes during chincup versus facemask treatment, to compare the long-term effects of the two appliances, and to document the impact of each on treatment success.


METHODS
In all, 61 patients with Class III syndrome were retrospectively analyzed at three examination times: 7.8 ± 1.7 years of age (T0, pretreatment), 9.6 ± 2.4 years of age (T1, posttreatment), and around 15-20 years later (T2, long-term follow-up).


RESULTS
Significant changes of specific cephalometric parameters for all treatment times: T0-T1 (SNA, interbase and gonial angle, Björk's sum angle, maxillomandibular differential, and distance of upper lip to esthetic line), T1-T2 (NL-NSL, SNB, mandibular-body length, effective mandibular length, and effective maxillary length), and T0-T2 (mandibular-body length, effective mandibular length, effective maxillary length, maxillomandibular differential, SNB, ANB, gonial angle, Björk's sum angle, and Wits appraisal). The T1-T2 results illustrate that in both treatment groups the typical Class III growth pattern often reappeared after treatment, including gains in SNB angle, condylion-gnathion length, and gonion-menton distance.


CONCLUSIONS
Either a facemask or a chincup may be effectively used to treat Class III malocclusion. There were differences in long-term stability. Maxillary development was similarly favorable in both groups of patients with successful outcome. The subgroup in whom chincup treatment had failed were mainly characterized by excessive mandibular growth, or lack of maxillary catch-up growth, with deterioration of the maxillomandibular relationship notably in the initial phase of treatment. Early chincup treatment did not have an adverse impact on the temporomandibular joints.
Department of Oral Surgery and Orthodontics, Medical University Graz, Graz, Austria. brigitte.wendl@medunigraz.at.
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Wendl
Department of Oral Surgery and Orthodontics, Medical University Graz, Graz, Austria.
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Stampfl
Department of Oral Surgery and Orthodontics, Medical University Graz, Graz, Austria.
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Muchitsch
Department of Oral Surgery and Orthodontics, Medical University Graz, Graz, Austria.
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Droschl
Private Practice, Bregenz, Austria.
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Winsauer
Departamento de Ortodoncia y Ortopedia dento-facial, Universitat Internacional de Catalunya, Barcelona, Spain.
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Walter
Institute of Software Development and Biomedical Engineering, Technical University Graz, Graz, Austria.
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Wendl
Institute of Software Development and Biomedical Engineering, Technical University Graz, Graz, Austria.
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Wendl
D000293:Adolescent; D002508:Cephalometry; D002648:Child; D005115:Extraoral Traction Appliances; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D016382:Orthodontic Appliance Design; D009971:Orthodontics, Corrective; D012189:Retrospective Studies; D014087:Tooth Movement Techniques; D055815:Young Adult
Chincup; Class III syndrome; Facemask; Longterm stability; Orthopedic appliances