Major considerations of minimally invasive orthognathic surgery in Class III malocclusions: a systematic review

Abstract

Introduction: In Brazil, malocclusion is found in the ages between 7 and 15 years old with a prevalence of 6%. In this scenario, Class III malocclusion affects between 5% and 15% of the entire Brazilian population. Orthodontics stands out due to the strong aesthetic impairment and unfavorable treatment prognosis, especially when there is a hereditary component. It is suggested that most cases of Class III malocclusion have retrusion or maxillary hypoplasia, which may or may not be associated with mandibular prognathism. Thus, several treatment modalities are proposed to correct Class III malocclusion. Objective: It explored the literary findings on the importance of knowing the advances in orthodontics for the treatment of class III malocclusion. Methods: Clinical studies (case reports, retrospective, prospective and randomized) with qualitative and / or quantitative analysis were included, following the rules of the systematic review-PRISMA. 134 articles were found initially and, after selection, 37 articles were used to compose the present study. Results and conclusion: According to the literary findings, the treatment of Class III must be fundamentally based on the diagnosis so that the treatment is installed in order to correct the compromised structures instead of being compensated in places not affected by this malocclusion. In other words, the degree of involvement of the maxilla and mandible should be evaluated so that the treatment is directed to that bone base and really reaches its objectives and impacts of facial improvement. Growth redirection in Class III cases is indicated as soon as the anomaly is diagnosed, since the displacement processes that occur on the middle face can only be affected with treatment as long as the growth zones are able to respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the effects of facial correction.