Journal of Peking University(Health Sciences) >
Orthodontic-orthognathic treatment stability in skeletal class Ⅲ malocclusion patients
Received date: 2018-10-07
Online published: 2019-02-26
Supported by
Supported by the National Natural Science Foundation of China(81801014)
Objective:To investigate stability of skeletal hard tissues, dental hard tissues and soft tissues after orthodontic-orthognathic treatment in a long term. This study reviewed longitudinal changes in orthodontic-orthognathic patients of skeletal class Ⅲ malocculsion, using lateral cephalometric radiographs in 3-12 years after treatment in comparison to treatment finishing. Methods: Twenty-two patients with skeletal Class Ⅲ malocclusion following orthodontic-orthognathic surgery in Peking University School and Hospital of Stomatology from January 1, 2000 to January 1, 2009 were observed. The lateral cephalometric radiographs of the following stages were collected: treatment finishing (T1), 3 to 12 years after treatment (T2). Statistical analyses of cephalometrics were evaluated. Paired student t test was performed by SPSS 17.0. Results: Data of all the 22 patients were studied in longitudinal timeline after treatment and 3-12 years after treatment. From T1 to T2, we evaluated 11-SN (angle between the upper incisors axis and SN plane), 11-NA angle (angle between the upper incisors axis and NA plane), 11-NA mm (perpendicular distance from upper incisors to NA plane), 11-41(angle between the upper incisors axis and lower incisors axis), 41-NB angle (angle between lower incisors and NB plane), 41-NB(perpendicular distance from lower incisors to NB plane), 41-MP angle (angle between lower incisors and GoGn plane), and IMPA [angle between lower incisor and mandibular plane (tangent line to submandibular border)]. Most hard tissues of the teeth remained stable but upper anterior teeth angulations decreased, indicating by significantly reducing 11-SN (T1:110.98°±6.77°; T2: 109.21°±5.80°; P=0.005); reducing 11-NA(T1: 28.31°±6.80°;T2: 26.49°±6.18°; P=0.002); increasing 11-41 (T1:123.51°±8.14°;T2:125.7°±10.01°;P=0.035). From T1 to T2, we also evaluated SNA (angle of sella-nasion-A-point ), SNB (angle of sella-nasion-B-point), ANB (angle of A-point-nasion-B-point), GoGn-SN(angle between GoGn and SN plane), GoGn-FH (angle between GoGn and Frankfort plane), Y axis(angel between Sella-Gn and Frankfort plane), N-ANS (distance from nasion point to ANS point), ANS-Me (distance from ANS point to Menton point), N-Me (distance from nasion point to Menton point), ANS-Me/N-Me% (proportion of ANS-Me to N-Me), and FMA (angle between Frankfort and mandibular plane), Wits appraisal (horizontal distance between points A and B on functional occlusal plane). Skeletal hard tissues also remained relatively stable, only N-Me value changed significantly with a decreasing facial height (T1:124.98°±11.98°; T2:122.4°±11.05°; P=0.024). From T1 to T2, we finally evaluated FH-NsPg angle (angle between NsPg and Frankfort plane), H angle (angel between H line and NB), FH-A’UL angle (angle between A’UL and Frankfort plane), FH-B’LL angle (angle between B’LL and Frankfort plane), UL-LL (angle between UL and LL), UL-EP (distance between UL and E line), LL-EP (distance between LL and E line), Sn-H(perpendicular distance between Sn point and H line), Nls-H (distance of nose-lip-sulcus to H line), Li-H (lower lip to H line), Si-H (lower lip sulcus to H line), and NLA (nasolabial angle, angle of Cm-Sn-UL-point).Soft tissues changes were observed in decreasing UL-EP [T1: (-2.78±2.20) mm; (-3.29±2.44) mm; P=0.02] and H angle(T1: 8.27°±3.71°; 7.32°±3.83°; P=0.006).Other soft tissues remained relatively stable by retruding upper lip position and chin changes with no statistical significance. Conclusion: Orthodontic-orthognathic treatment can improve esthetics and occlusal function in patients of skeletal class Ⅲ malocclusion with a stable long-term outcome.
Xiu-jing WANG , Yi-mei ZHANG , Yan-heng ZHOU . Orthodontic-orthognathic treatment stability in skeletal class Ⅲ malocclusion patients[J]. Journal of Peking University(Health Sciences), 2019 , 51(1) : 86 -92 . DOI: 10.19723/j.issn.1671-167X.2019.01.016
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