Orthopedic treatment outcomes in Class III malocclusion. A systematic review

OBJECTIVE: To assess the scientific evidence on the effectiveness of early orthopedic treatment in Class III subjects. MATERIALS AND METHODS: A literature survey was performed by applying the Medline database (Entrez PubMed). The survey covered the period from January 1966 to December 2005 and used the Medical Subject Headings (MeSH). The following study types that reported data on the effects of Class III treatment with orthopedic appliances (facial mask, chincup, FR-3) on intermaxillary sagittal and vertical relationships were included: randomized clinical trials (RCTs), and prospective and retrospective longitudinal controlled clinical trials (CCTs) with untreated Class III controls. RESULTS: The search strategy resulted in 536 articles. After selection according to criteria for inclusion and exclusion, 19 articles qualified for the final review analysis. One RCT and 18 CCTs were retrieved. CONCLUSION: The quality standard of the retrieved investigations ranged from low (four studies) to medium/high (five studies). Data derived from medium/high quality research described over 75% of success of orthopedic treatment of Class III malocclusion (RME and facial mask therapy) at a follow-up observation 5 years after the end of orthopedic treatment.