Clinical Outcomes of Skeletal Anchorage Versus Conventional Anchorage in the Class III Orthopaedic Treatment in Growing Patients: A Systematic Review and Meta-Analysis - Turkish Journal of Orthodontics

Background: The aim of this study was to evaluate the correlation between skeletal class and dental dimensions analyzed through linear, surface area, and volumetric measurements. Methods: The sample consisted of 90 patients with an average age of 18 years (44 > x > 12). The following tests were used to investigate any correlation between skeletal class and tooth size: Hoeffding’s test, Cramér’s V test, and analysis of variance (ANOVA), followed by Tukey’s post hoc HSD test and the logit model. The significance level was set at 0.050. Results: Cramér’s V test indicated a weak association between skeletal class (I, II, III) and total Bolton index (V = 0.167, p < 0.01). The ANOVA results showed that the total inferior volume and the anterior inferior volume were significantly greater (p = 0.012; p = 0.012) in skeletal class III (p = 0.012) than in the other two skeletal classes. The total upper surface area was significantly greater in patients with skeletal class III compared to those with classes II and I (p = 0.029). The anterior superior surface area was significantly greater in skeletal class III than in class II and I (p = 0.028). From the results of the logit analysis, it is possible to state that the third model is able to explain greater variability (21%) in terms of the distribution of results for the variables considered than the first (20%) and the second (14%). Conclusions: Class III skeletal malocclusions are characterized by increased tooth surface and volumetric dimensions compared to class I and class II.

Background: The aim of this study was to evaluate the correlation between skeletal class and morphological patterns of the mandibular symphysis. Methods: The sample consisted of 90 patients with an average age of 18 years (44 > x > 12). In order to investigate any correlation between skeletal class and morphological patterns of the mandibular symphysis, the following tests were used: Pearson’s correlation test, Spearman’s test, and the analysis of variance test (ANOVA) followed by Tukey’s post hoc HDS test. The significance level was set at 0.050. Results: Pearson’s correlation test and ANOVA showed a weak negative correlation between malocclusion and symphyseal height. Therefore, as ANB increases, symphyseal height decreases (r = −0.25, p < 0.01). In addition, a strong positive correlation was found between ANB and IMPA (r = 0.47, p < 0.01). So, as ANB increases, IMPA increases. No statistically significant association was found between symphyseal morphology and IMPA (Spearman’s test). Conclusions: The analysis revealed a weak but statistically significant negative correlation between ANB angle and symphysis height, indicating that as sagittal discrepancy increases (higher ANB), the symphysis tends to be shorter (r = −0.25, p < 0.01). A moderate positive correlation was also found between ANB and IMPA (r = 0.47, p < 0.01), suggesting that a more pronounced Class II skeletal pattern is associated with greater incisor proclination. However, no significant relationship was observed between symphysis type (A/B/C) and IMPA. When comparing skeletal classes, Class III subjects displayed significantly greater symphyseal height than Class II subjects (p < 0.001), while Class II subjects showed the highest IMPA values (p < 0.001).

Background: Newborns with Pierre Robin Sequence (PRS) usually show varying degrees of upper airway obstruction and difficulty feeding due to severe micrognatia. Mandibular distraction osteogenesis has become popular as an alternative treatment option when other medical or surgical techniques are unsatisfactory. The aim of this study is to test a three-dimensional (3D) cephalometric method in computed tomography (CT) to measure effective mandibular and midface length, and maxillomandibular ratio (Md/Mx ratio), as a mode of growth normalization expression in PRS patients before and after Fast and Early Mandibular Osteo-distraction (FEMOD), for assessing the diagnostic method and the efficacy of surgical treatment. Methods: In this retrospective pilot study, six PRS patients treated via the FEMOD surgical protocol were included. The measurements of effective maxillary and mandibular length were performed on 3D reconstructions from pre-surgical (T1) and post-surgical CT (T2). The growth disparity between the mandible and the maxilla was verified in T1 and was compared with the measurements obtained from the adaptation of the McNamara Norms; the correction of growth disproportion after FEMOD was assessed. Results: In T1, the PRS patients’ mandibular length and the Md/Mx ratio were smaller than the expected mandibular length (p = 0.029) and the expected Md/Mx ratio (p = 0.028). In T2, the PRS patients’ mandibular length and the Md/Mx ratio did not show significant differences from the expected results (p = 0.461 and p = 0.400). Conclusions: The 3D cephalometric analysis identifies the disproportion in pre-surgical maxillomandibular growth between PRS and reference measurements, and demonstrates that FEMOD allows the achievement of proportionality in the growth of the maxillomandibular complex in PRS patients.