Long-term skeletal and dental effects of facemask versus chincup treatment in Class III patients: A retrospective study

OBJECTIVES: To investigate the skeletal and dental changes during chincup versus facemask treatment, to compare the long-term effects of the two appliances, and to document the impact of each on treatment success. METHODS: In all, 61 patients with Class III syndrome were retrospectively analyzed at three examination times: 7.8 ± 1.7 years of age (T0, pretreatment), 9.6 ± 2.4 years of age (T1, posttreatment), and around 15–20 years later (T2, long-term follow-up). RESULTS: Significant changes of specific cephalometric parameters for all treatment times: T0–T1 (SNA, interbase and gonial angle, Björk’s sum angle, maxillomandibular differential, and distance of upper lip to esthetic line), T1–T2 (NL-NSL, SNB, mandibular-body length, effective mandibular length, and effective maxillary length), and T0–T2 (mandibular-body length, effective mandibular length, effective maxillary length, maxillomandibular differential, SNB, ANB, gonial angle, Björk’s sum angle, and Wits appraisal). The T1–T2 results illustrate that in both treatment groups the typical Class III growth pattern often reappeared after treatment, including gains in SNB angle, condylion-gnathion length, and gonion-menton distance. CONCLUSIONS: Either a facemask or a chincup may be effectively used to treat Class III malocclusion. There were differences in long-term stability. Maxillary development was similarly favorable in both groups of patients with successful outcome. The subgroup in whom chincup treatment had failed were mainly characterized by excessive mandibular growth, or lack of maxillary catch-up growth, with deterioration of the maxillomandibular relationship notably in the initial phase of treatment. Early chincup treatment did not have an adverse impact on the temporomandibular joints.