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Determination of treatment options for Class III malocclusions in adult patients based on cephalometric values: a systematic review

Open Access
|Jul 2022

Figures & Tables

Figure 1.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram of the included studies.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram of the included studies.

The search engines included keywords, date of searches and data retrieved_

Search EnginesKeywordsDateResultsInternal duplicatesExternal duplicatesExclusion by titleExclusion by abstractExclusion by full textFinal
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”))18.09.2021384212103711424
PUBMEDSame as above18.09.202113332403919342
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)18.09.202164816470000
Web of ScienceSame as above18.09.2021371128188100
ScopusSame as above18.09.202168391119474880100
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”)]18.09.20210000000
Total 1303313632789598966

Characteristics of the included studies_

StudyStudy designStudy settingParticipantsMean ageGender
Stellzig-Eisenhauer, Lux and Schuster 200214Retrospective studyDepartments of Orthodontics of the Universities of Frankfurt, Heidelberg, and Würzburg, Germany.Total sample: 175CG: 87SG: 88Overall: NACG: NASG: NA*Sample of adult patientOverall: M: 82;F: 93
Eslami et al. 201815Retrospective studyPrivate practice orthodontic office in IranTotal sample: 65CG: 36SG: 29Overall: NACG: 23.5 ± 4.8, SG: 24.8 ± 3.1Overall: M: 27;F: 38CS: M: 15; F: 21SG: M: 12; F: 17
Benyahia et al. 201121Retrospective studyOrthodontics unit at the CHIS dental consultation and treatment center in Rabat, Morocco, and the Clairval CHP maxillofacial and esthetic clinic in Marseille, FranceTotal sample: 47CG: 22SG: 25Overall: NACG: NASG: NA*Sample of adult patientOverall: NACG: NASG: NA
Kochel et al. 201122Retrospective studyDepartment of Orthodontics of the University of Wuerzburg in Germany and from 7 cooperative private practicesTotal sample: 69CG: 28SG: 41Overall: NACG: Mean 27.6, Median 23.6SG: Mean 26.3, Median 24.2Overall: NACG: NASG: NA
Tseng et al. 201123Retrospective studyTaiwanTotal sample: 80CG: 40SG: 40Overall: 23 years range, 18–34Overall: M: 40;F: 40
Watanabe et al. 202024Retrospective studyBrazilTotal sample: 60CG: 30SG: 30Overall: NACG:18.5 ± 4.4SG: 20.1 ± 2.4Overall: M: 29;F: 31CS: M: 13; F: 17SG: M: 16; F: 14

Risk of bias of included studies_

Author and yearStudy designSettingParticipants criteriaSample sizeVariable descriptionOutcome measurementStatistical testTotal scoreQuality of the studies
Stellzig-Eisenhauer, Lux and Schuster 200214XX5Moderate
Eslami et al. 201815X6High
Benyahia et al. 201121XXX4Moderate
Kochel et al. 201122XXX4Moderate
Tseng et al. 201123XX5Moderate
Watanabe et al. 2020246High

Cephalometric cut off values for Class III camouflage or surgery_

Measurement StudyHoldaway angle1) Wits appraisal, (2) M/M ratio, (3) saddle angle, and (4) mand MLDOverjetWits appraisalL1-MP angleMx/Mn ratioOverbiteGonial 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. 200214NANANANANANANANAThe 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. 20181510.3° (above can be treated by camouflage-below can treated by surgery)NANA≤-5.8 mm (treated by surgery)NANANANANA
Benyahia et al. 2011217.2° (above can be treated by camouflage-below can treated by surgery)NANANANANANANANA
Kochel et al. 201122NAThe 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)NANANANANANANA
Tseng et al. 201123NANA≤-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
DOI: https://doi.org/10.2478/aoj-2022-0021 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 183 - 193
Submitted on: Feb 1, 2022
Accepted on: Jun 1, 2022
Published on: Jul 14, 2022
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2022 Saritha Sivarajan, Nor Nadia Zakaria, Noor Asyikin Azmily, Mang Chek Wey, Mohamed Abd El-Ghafour, Mona M. Salah Fayed, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.