International Journal of Clinical Pediatric Dentistry

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VOLUME 16 , ISSUE 6 ( November-December, 2023 ) > List of Articles


Posttreatment Stability Following Facemask Therapy in Patients with Skeletal Class III Malocclusion: A Systematic Review

Yuvashree Raghupathy, Venkateswaran Ananthanarayanan, Vignesh Kailasam, Sridevi Padmanabhan

Keywords : Facemask, Protraction facemask, Relapse, Stability

Citation Information : Raghupathy Y, Ananthanarayanan V, Kailasam V, Padmanabhan S. Posttreatment Stability Following Facemask Therapy in Patients with Skeletal Class III Malocclusion: A Systematic Review. Int J Clin Pediatr Dent 2023; 16 (6):897-907.

DOI: 10.5005/jp-journals-10005-2686

License: CC BY-NC 4.0

Published Online: 01-02-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Background: Skeletal class III malocclusion is a challenging condition that orthodontists frequently come across. The facemask (FM) is a device commonly used to treat this malocclusion. However, the stability of this orthopedic correction remains unclear, and collective documentation of the short-, mid-, and long-term stability after FM therapy is necessary. Aim: The aim of the systematic review was to assess posttreatment stability following FM therapy in patients with skeletal class III malocclusion. Materials and methods: Through a predefined search strategy, electronic searching was conducted in PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane, Ovid, Embase, Scopus, and Web of Science until 30th June 2022. Eligible study selection, data extraction, and evaluation of the risk of bias were performed independently by two review authors according to the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2.0 tool) and the Risk of Bias in Nonrandomized Studies–of Interventions (ROBINS-I) tool for nonrandomized trials. A total of 14 studies were finally considered eligible. The systematic review revealed that the maxillo-mandibular differential reverted to class III. The maxillary changes achieved were variable, with SNA angles ranging between −0.7° and 1.9°. Changes in the mandible were greater with an increase in the SNB angle ranging between 0.33° and 3.62°. The lower anterior facial height increased. The maxillary and mandibular incisors were proclined, and the overjet and overbite decreased. The soft tissue changes were insignificant. Conclusion: The effects of FM therapy were found to be stable in the short-term follow-up period. The long-term follow-up revealed that the effects of FM therapy remained stable for the maxilla. However, the mandible continued to grow in a horizontal and unfavorable direction until the adolescent growth spurt. Clinical significance: The major variable that determines the long-term success of FM therapy is the amount and direction of mandibular growth during the adolescent growth spurt. More focus on restricting unfavorable mandibular growth and duration of retention is needed for post-FM therapy. Others: PROSPERO (CRD42021218960).

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