Prognostic approach to Class III malocclusion through case-based reasoning

Objective: This investigation evaluates the evidence of case-based reasoning (CBR) in providing additional information on the prediction of future Class III craniofacial growth. Settings and sample population: The craniofacial characteristics of 104 untreated Class III subjects (7-17 years of age), monitored with two lateral cephalograms obtained during the growth process, were evaluated. Materials and methods: Data were compared with the skeletal characteristics of subjects who showed a high degree of skeletal imbalance (‘prototypes’) obtained from a large data set of 1263 Class III cross-sectional subjects (7-17 years of age). Results: The degree of similarity of longitudinal subjects with the most unbalanced prototypes allowed the identification of subjects who would develop a subsequent unfavourable skeletal growth (accuracy: 81%). The angle between the palatal plane and the sella-nasion line (PP-SN angle) and the Wits appraisal were two additional craniofacial features involved in the early prediction of the adverse progression of the Class III skeletal imbalance. Conclusions: Case-based reasoning methodology, which uses a personalized inference method, may bring additional information to approximate the skeletal progression of Class III malocclusion.