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Objective: To assess the short‐ and long‐term dentoskeletal effects of early Class III treatment with rapid maxillary expansion and facemask (RME/FM) followed by fixed appliances. Materials and Methods: A total of 44 patients (27 females, 17 males) treated consecutively with RME/FM were included from the archives of 3 centres. Three lateral cephalograms were available: T0 (before the start of RME/FM therapy, mean age 8.1 ± 1.8 years), T1 (immediately after RME/FM, mean age 9.8 ± 1.6 years), and T2 (long‐term observation, mean age 19.5 ± 1.6 years). A control group of 17 untreated Class III subjects (12 females and 5 males) also was selected. Between‐group statistical comparisons were performed with ANCOVA. Results: No statistically significant differences for any of the cephalometric variables were found at T0. In the short term, the treated group showed significant improvements in ANB (+2.9°), Wits appraisal (+2.7 mm), SNA (+1.8°) and SNB (−1.1°). A significant closure of CoGoMe angle (−1.3°) associated with smaller increments along Co‐Gn (−2.4 mm) also was found together with a significant increase in intermaxillary divergence (+1.3°). In the long‐term, significant improvements in ANB (+2.6°), Wits appraisal (+2.7 mm) and SNB (−1.7°) were recorded together with a significant closure of the CoGoMe angle (−2.9°). No significant long‐term changes in vertical skeletal relationships were found. Conclusions: RME/FM therapy was effective in improving Class III dentoskeletal relationships in the short term. These changes remained stable in the long‐term due mainly to favourable mandibular changes. [ABSTRACT FROM AUTHOR]

Background Skeletally anchored facemask has been proposed to maximize skeletal effects and minimize dental effects in the treatment of Class III malocclusion in growing patients. Objective To compare the dento-skeletal effects produced by the facemask with or without skeletal anchorage for the treatment of Class III malocclusion in growing patients. Materials and methods PubMed, Cochrane Library, Scopus, Embase, Web of Science, and OpenGrey were used for the electronic search without language, publication status, and year restrictions. Only RCTs were included. Inclusion criteria were: growing patients (age under 18 years) with Class III malocclusion, with indications for treatment with the facemask. Data were extracted by two independent reviewers. GRADE statement was executed. The mean of differences (MD) and the risk ratio (RR) were used. Results Three articles with a total of 123 patients were included. One article was at low risk of bias while two were at high risk of bias. There were no significant differences between the two groups in ANB angle, Wits appraisal, SNB angle, and SN-MP angle. SNA angle was significantly increased in the skeletally anchored facemask (pooled MD = 0.80 favouring skeletal anchorage, 95% CI from 0.29 to 1.31, P = 0.002, I 2 = 12 per cent, three studies, GRADE moderate). The U1-SN angle was significantly reduced in the skeletally anchored facemask (pooled MD = −5.91 favouring skeletal anchorage, 95% CI from −7.64 to −4.27, P < 0.00001, I 2 = 0 per cent, two studies, GRADE moderate). There were significantly less complications in tooth-anchored facemask (pooled RR = 7.98 favouring dental anchorage, 95 per cent CI from 1.04 to 61.27, P = 0.05, I 2 = 0 per cent, two studies, GRADE low). Limitations Few RCTs (three) were included, and two studies were at high risk of bias. There were no long-term RCTs comparing skeletally anchored facemask with dental-anchored facemask. Only Asiatic patients were included in this systematic review. Conclusions Skeletally anchored facemask was associated to a greater increase of SNA angle at the end of treatment though clinically not significant. Facemask with skeletal anchorage determined a reduced inclination of maxillary incisors compared to dental-anchored facemask with greater risks of complications. Registration PROSPERO register (CRD42020221982). [ABSTRACT FROM AUTHOR]

Objective: To analyse the craniofacial growth of a long-term semi-longitudinal sample of Caucasian subjects with untreated Class III malocclusion.Setting and Sample Population: A total of 144 Caucasian subjects (of North American and Italian origin) with untreated Class III malocclusion.Materials and Methods: Subjects aged 2 years and 9 months up to 21 years and 7 months were selected. A multilevel model was used to calculate growth curves for ten variables for both each individual subject and for the whole sample.Results: There was a statistically significant increase for total mandibular length (Co-Gn. T2-T1 = 8.4 mm), midfacial length (Co-A. T2-T1 = 3.4 mm) and lower anterior facial height (ANS-Me. T2-T1 = 3.8 mm). The multilevel analysis showed two points of acceleration of growth (about 3-5 years of age and 11-15 years of age) for seven out of ten variables. For Co-Gn and Co-A variables, males presented points of maximum growth delayed by 1 year in comparison with females, with a greater duration (1 year longer) and a greater total growth of about 5 mm. Active mandibular growth continued for a long time after the pubertal spurt: increases in mandibular length ended at about 17 years of age in females and at 21 years and 7 months in males.Conclusions: Untreated Class III malocclusion showed a specific growth curve, especially for the mandible, whose excesses added up over time. In males, the amounts of mandibular and midfacial growth during the whole observation time were greater and lasted longer than in females. [ABSTRACT FROM AUTHOR]

Background: This prospective two-center case series feasibility study aimed to investigate the potential of a novel maxillary protraction facemask customized to the patients' anatomy recorded with 3D face scanning and then produced by digital design and additive manufacturing., Methods: Ten subjects (5 females and 5 males, average age 7.7±1.0 years) with Class III malocclusion were treated with a rapid maxillary expander (RME) and a Petit-type facemask (FM), whose components were digitally designed on a 3D scan of the patient's face. Subjects' face scans were obtained either with a tablet or with face scanner. FM components were modelled with a 3D software. The pads were 3D printed in biocompatible resin, and the bar was printed in stainless steel. A questionnaire investigating the patients' experience was filled in after the first week of treatment and after 3, 6, and 9 months., Results: The customized FM showed an excellent adaptation to the anatomy of the face. No severe complications were reported during the 9 months of appliance wearing. Some reversible episodes of skin irritation were reported below the pads, mainly in the chin area. The reported time wearing ranged between 8.2±2.3 and 9.5±1.2 hours per day, mainly at night. Reported pain was overall low (maximum after 1 week with an average value of 1.9±1.7 on a visual analog scale [VAS] 0-10) and patients' satisfaction was adequate at the end of the facemask wear after 9 months (8.7±1.4 on a VAS 0-10)., Conclusions: The customized FM was overall well accepted by the patients and represents a valid alternative to conventional ones.