Preliminary investigation of nonsurgical treatment of severe skeletal Class III malocclusion in the permanent dentition.

The purpose of the study was to analyze the effects of nonsurgical treatment on subjects with a severe skeletal Class III deformity and to directly evaluate dental and facial profile changes. Eighteen patients with severe skeletal Class III malocclusions (5 males, 13 females), diagnosed as indication for orthognathic surgery, were included in the study. The average age was 13.7 +/- 2.5 years. All the cases were treated with Tip-Edge straight-wire technique or Begg light wire technique. Lateral cephalometric films taken at the beginning and at the end of treatment were analyzed with the Pancherz analysis and traditional cephalometric analysis. The arithmetic mean and standard deviation were calculated for each variable and paired t-test was performed. A mean reduction of 6.5 mm in the overjet was noted (P < .001), with skeletal changes and dental changes contributing 20% and 80% to the overjet correction, respectively. The inclination of the upper incisors to the SN plane was increased 5.9 degrees (P < .01). The inclination of the lower incisors to the mandibular plane was decreased 6.6 degrees (P < .001). The difference between the distance of the upper lip and lower lip to Sn-Pg' at the beginning of treatment changed from a negative value to a positive value with a significant difference (P < .001). Successful treatment effects can be obtained with nonsurgical therapy in severe skeletal Class III malocclusions in the permanent dentition. A remarkable soft tissue change was noted after the treatment, and the concave facial profile changed to a straight profile (see two case reports).