SKELETAL EFFECTS OF EARLY TREATMENT OF CLASS-III MALOCCLUSION WITH MAXILLARY EXPANSION AND FACE-MASK THERAPY

The effectiveness of maxillary expansion and face-mask therapy in chil dren with Class III malocclusion was studied in a sample of 46 subject s in mixed dentition and compared with a control sample of 32 subjects with untreated Class III malocclusion. Treated and untreated samples were divided into early and late mixed-dentition groups to aid identif ication of the optimum timing of the orthopedic treatment of the under lying skeletal disharmony. Cephalometric analysis was based on a stabl e basicranial reference system, appropriate for longitudinal studies s tarted in the early developmental ages. The level of significance for intergroup comparisons was set al a p value of 0.01. Significant forwa rd displacement of the maxillary complex was found in the early-treatm ent group. The region of the pterygomaxillary suture, in particular, s howed significant changes in the subjects treated during early mixed d entition. No significant maxillary modifications were recorded in the late-treatment group. Both early and late groups exhibited smaller inc rements in mandibular protrusion and larger increments in the intermax illary vertical relationship compared with their respective Class III control groups. Only children treated at an early age, however, showed a significant upward and forward direction of condylar growth, leadin g to smaller increments in total mandibular length. These results indi cate that the combination of a bonded maxillary expander and face-mask therapy is more effective in early mixed dentition than in late mixed dentition, especially with regard to the magnitude of the protraction effects on maxillary structures.