Determination of treatment options for Class III malocclusions in adult patients based on cephalometric values: a systematic review
, , , , and | Jul 14, 2022
About this article
Published Online: Jul 14, 2022
Page range: 183 - 193
Received: Feb 01, 2022
Accepted: Jun 01, 2022
DOI: https://doi.org/10.2478/aoj-2022-0021
© 2022 Saritha Sivarajan et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Figure 1.
The search engines included keywords, date of searches and data retrieved.
| Search Engines | Keywords | Date | Results | Internal duplicates | External duplicates | Exclusion by title | Exclusion by abstract | Exclusion by full text | Final |
|---|---|---|---|---|---|---|---|---|---|
| Science Direct | ((“Orthodontics” OR “Camouflage”) AND (“Surgery” OR “Orthognathic Surgery” OR “Dental Decompensation”) AND (“Class III” OR “Angle Class III” OR “Skeletal Class III” OR “Class III malocclusion”)) | 18.09.2021 | 3842 | 121 | 0 | 3711 | 4 | 2 | 4 |
| PUBMED | Same as above | 18.09.2021 | 1333 | 2 | 403 | 919 | 3 | 4 | 2 |
| Ovid | (Orthodontics or Camouflage) and (Surgery or Orthognathic Surgery or Dental Decompensation) and (Class III or Angle Class III or Skeletal Class III or Class III malocclusion) | 18.09.2021 | 648 | 1 | 647 | 0 | 0 | 0 | 0 |
| Web of Science | Same as above | 18.09.2021 | 371 | 1 | 281 | 88 | 1 | 0 | 0 |
| Scopus | Same as above | 18.09.2021 | 6839 | 11 | 1947 | 4880 | 1 | 0 | 0 |
| OpenGrey | [(“Orthodontics” OR “Camouflage” OR “Orthodontic Camouflage”) AND (“Surgery” OR “Orthognathic Surgery” OR “Dental Decompensation”) AND (“Class III” OR “Angle Class III” OR “Skeletal Class III” OR “Class III malocclusion”)] | 18.09.2021 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Total | 13033 | 136 | 3278 | 9598 | 9 | 6 | 6 |
Characteristics of the included studies.
| Study | Study design | Study setting | Participants | Mean age | Gender |
|---|---|---|---|---|---|
| Stellzig-Eisenhauer, Lux and Schuster 2002 |
Retrospective study | Departments of Orthodontics of the Universities of Frankfurt, Heidelberg, and Würzburg, Germany. | Total sample: 175 |
Overall: NA |
Overall: M: 82; |
| Eslami et al. 2018 |
Retrospective study | Private practice orthodontic office in Iran | Total sample: 65 |
Overall: NA |
Overall: M: 27; |
| Benyahia et al. 2011 |
Retrospective study | Orthodontics unit at the CHIS dental consultation and treatment center in Rabat, Morocco, and the Clairval CHP maxillofacial and esthetic clinic in Marseille, France | Total sample: 47 |
Overall: NA |
Overall: NA |
| Kochel et al. 2011 |
Retrospective study | Department of Orthodontics of the University of Wuerzburg in Germany and from 7 cooperative private practices | Total sample: 69 |
Overall: NA |
Overall: NA |
| Tseng et al. 2011 |
Retrospective study | Taiwan | Total sample: 80 |
Overall: 23 years range, 18–34 | Overall: M: 40; |
| Watanabe et al. 2020 |
Retrospective study | Brazil | Total sample: 60 |
Overall: NA |
Overall: M: 29; |
Risk of bias of included studies.
| Author and year | Study design | Setting | Participants criteria | Sample size | Variable description | Outcome measurement | Statistical test | Total score | Quality of the studies |
|---|---|---|---|---|---|---|---|---|---|
| Stellzig-Eisenhauer, Lux and Schuster 2002 |
√ | X | √ | X | √ | √ | √ | 5 | Moderate |
| Eslami et al. 2018 |
√ | √ | √ | X | √ | √ | √ | 6 | High |
| Benyahia et al. 2011 |
X | X | √ | X | √ | √ | √ | 4 | Moderate |
| Kochel et al. 2011 |
X | X | √ | X | √ | √ | √ | 4 | Moderate |
| Tseng et al. 2011 |
√ | X | √ | X | √ | √ | √ | 5 | Moderate |
| Watanabe et al. 2020 |
√ | √ | √ | √ | √ | √ | √ | 6 | High |
Cephalometric cut off values for Class III camouflage or surgery.
| Measurement Study | Holdaway angle | 1) Wits appraisal, (2) M/M ratio, (3) saddle angle, and (4) mand MLD | Overjet | Wits appraisal | L1-MP angle | Mx/Mn ratio | Overbite | Gonial angle | (1) Wits appraisal, (2) length of the anterior cranial base, (3) maxillary/mandibular (M/M) ratio, and (4) lower gonial angle. |
|---|---|---|---|---|---|---|---|---|---|
| Stellzig-Eisenhauer et al. 2002 |
NA | NA | NA | NA | NA | NA | NA | NA | The critical score was -0.023 (above can be treated by camouflage-below can treated by surgery) (score = -1.805 + 0.209 · Wits + 0.044 · S-N + 5.689 · M/M ratio - 0.056 · Golower) |
| Eslami et al. 2018 |
10.3° (above can be treated by camouflage-below can treated by surgery) | NA | NA | ≤-5.8 mm (treated by surgery) | NA | NA | NA | NA | NA |
| Benyahia et al. 2011 |
7.2° (above can be treated by camouflage-below can treated by surgery) | NA | NA | NA | NA | NA | NA | NA | NA |
| Kochel et al. 2011 |
NA | The critical score was 0.251 (above can be treated by camouflage-below can treated by surgery) (score = –10.988 + 0.243 · Wits + 0.055 · M/M ratio + 0.068 · NSAr – 0.589 · mand MLD) | NA | NA | NA | NA | NA | NA | NA |
| Tseng et al. 2011 |
NA | NA | ≤-4.73 mm (treated by surgery) | ≤-11.18 mm (treated by surgery) | ≤80.8° (treated by surgery) | ≤65.9% (treated by surgery) | ≤-0.18 mm (treated by surgery) | ≥120.8° (treated by surgery) | NA |