Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in Class III malocclusion

Introduction: In this cephalometric investigation, we analyzed the treatment and posttreatment effects of an orthopedic protocol for Class III malocclusion consisting of a facial mask combined with a removable bite-block appliance. Methods: The treated sample consisted of 22 Class III patients treated with the facial mask and bite-block protocol before the pubertal growth spurt (mean age, 8.9 ± 1.5 years). Treated subjects were evaluated after facial mask and bite-block therapy and at a posttreatment observation in absence of retention. The treated group was compared with a matched control group of 12 untreated Class III subjects. All treated and control subjects were postpubertal at the final observation. Significant differences between the treated and control groups were assessed with the Mann-Whitney U test (P <0.05). Results: Both angular and linear sagittal measurements of the maxilla showed significant improvements during active treatment. Significant improvements of SNA angle, ANB angle, overjet, and molar relationship remained stable during the posttreatment period. No significant effect was found in the mandibular skeletal measures. No significant protraction of the maxillary incisors or retraction of the mandibular incisors was observed. Conclusions: A bite-block appliance in the mandibular arch with a facial mask enabled effective control of mandibular rotation with progressive closure of the gonial angle. This added to the favorable maxillary outcomes of the treatment protocol.