Soft tissue changes associated with Class III orthopaedic treatment in growing patients: a systematic review and meta-analysis.

IF 5 2区医学 Q1 Dentistry Progress in Orthodontics Pub Date : 2025-03-17 DOI:10.1186/s40510-025-00558-2

Ahmad Marwan Alhamwi, Ahmad Sharafeddin Burhan, Fehmieh Rafik Nawaya, Kinda Sultan

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Abstract

Introduction: Achieving a harmonious soft tissue profile and enhancing facial appearance are key goals of early treatment for skeletal class III malocclusion.

Aim: To summarize the current evidence regarding the effects of Class III orthodontic treatment on facial soft tissues, and to compare various Class III orthodontic appliances.

Methods: A comprehensive search was conducted up to July 2024, using seven databases, with no language restrictions. RCTs and controlled non-randomized studies were included in this systematic review. The GRADE framework was applied to evaluate the quality of evidence.

Results: Thirty studies were included in this review, of which sixteen were appropriate for quantitative synthesis. The age range fell between 6.6 and 12.3 years. The FM/RME protocol resulted in a 1.58 mm increase in upper lip protrusion and a 4.73-degree decrease in the nasolabial angle compared to the control group. Chincup treatment led to a 2.13 mm increase in upper lip protrusion and a 2.63 mm decrease in lower lip protrusion compared to the control group. The pooled estimate demonstrated a significant increase of 1.82 mm in upper lip protrusion, a significant retrusion of 3.14 mm in the lower lip, and a backward movement of the chin by 4.8 mm in patients treated with miniplate-anchored orthopaedic facemask (FM/MP) compared to the untreated group. However, no significant difference was found between FM/RME and FM/MP, except for a noticeable decrease in the nasolabial angle in the FM/RME group. The analysis of FM/Alt-RAMEC versus FM/RME did not reveal any difference in soft tissue outcomes, except for the upper lip protrusion. The Alt-RAMEC group showed a more pronounced anterior movement of the upper lip by 0.67 mm compared to the RME group. The quality of evidence supporting these findings ranged from low to moderate.

Conclusions: There is low to moderate evidence suggesting that early treatment positively influences the soft tissues in Class III patients. However, these conclusions are based on a two-dimensional analysis of cephalometric images, which may not provide complete or accurate information. Therefore, more RCTs using comprehensive 3D analysis are needed to confirm these results.

Registration: PROSPERO ( CRD42024517924 ).

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成长期患者III类骨科治疗相关软组织改变：系统回顾和荟萃分析

实现和谐的软组织轮廓和改善面部外观是早期治疗骨骼III类错颌畸形的关键目标。目的：总结目前关于III类正畸治疗对面部软组织影响的证据，并比较各种III类正畸矫治器。方法：综合检索截至2024年7月的7个数据库，无语言限制。本系统综述包括随机对照试验和对照非随机研究。GRADE框架用于评价证据质量。结果：本综述纳入30项研究，其中16项适合定量合成。年龄范围在6.6岁到12.3岁之间。与对照组相比，FM/RME方案导致上唇突出增加1.58 mm，鼻唇角减少4.73度。与对照组相比，青杯组的上唇突出量增加2.13 mm，下唇突出量减少2.63 mm。综合估计显示，与未治疗组相比，使用微型钢板固定矫形面罩（FM/MP）治疗的患者上唇突出显著增加1.82 mm，下唇明显后缩3.14 mm，下巴向后移动4.8 mm。然而，FM/RME组与FM/MP组之间除了FM/RME组鼻唇角明显减小外，无显著差异。FM/Alt-RAMEC与FM/RME的分析显示，除上唇突出外，软组织结果没有任何差异。与RME组相比，Alt-RAMEC组的上唇前移明显增加0.67 mm。支持这些发现的证据质量从低到中等不等。结论：有低到中等程度的证据表明，早期治疗对III类患者的软组织有积极影响。然而，这些结论是基于头部测量图像的二维分析，可能不能提供完整或准确的信息。因此，需要更多采用全面3D分析的随机对照试验来证实这些结果。注册：普洛斯彼罗（CRD42024517924）。

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来源期刊

Progress in Orthodontics Dentistry-Orthodontics

CiteScore

7.30

自引率

4.20%

发文量

审稿时长

13 weeks

期刊介绍： Progress in Orthodontics is a fully open access, international journal owned by the Italian Society of Orthodontics and published under the brand SpringerOpen. The Society is currently covering all publication costs so there are no article processing charges for authors. It is a premier journal of international scope that fosters orthodontic research, including both basic research and development of innovative clinical techniques, with an emphasis on the following areas: • Mechanisms to improve orthodontics • Clinical studies and control animal studies • Orthodontics and genetics, genomics • Temporomandibular joint (TMJ) control clinical trials • Efficacy of orthodontic appliances and animal models • Systematic reviews and meta analyses • Mechanisms to speed orthodontic treatment Progress in Orthodontics will consider for publication only meritorious and original contributions. These may be: • Original articles reporting the findings of clinical trials, clinically relevant basic scientific investigations, or novel therapeutic or diagnostic systems • Review articles on current topics • Articles on novel techniques and clinical tools • Articles of contemporary interest