Class III Treatment using Kiebach Expansion Appliance and Protraction Facemask

Objectives: To evaluate the treatment response and 2-year follow-up results of early orthopedic treatment of Class III malocclusions using the Kiebach expansion appliance and a protraction facemask.  Methods: Twenty three consecutively treated patients with CVM I skeletal maturation at the start of treatment were recruited for the study.  Average treatment time was 9 months. Lateral cephalograms were taken at pre-treatment (T1), post-treatment (T2), and 2 years follow-up (T3). Twenty-five sagittal, vertical, and angular cephalometric measurements were used to determine skeletal and dental changes. Data were analyzed using ANOVA and paired t-test.  Results: ANOVA revealed significant difference for the time periods: T2-T1, T3-T2, and T3-T1. During the 9 months of treatment (T2-T1), the mean overjet correction was 4.1mm. The maxilla moved forward 2.6mm, and the mandible moved forward 0.7mm. The maxillary incisors moved forward 1.2mm, and the mandibular incisors moved backward 1.0mm. The molar relationship was corrected into a more class I relationship. During the 2 year follow-up (T3-T2), the overjet change was -0.3mm. The maxilla continued to move forward 1.5mm, but the mandible also moved forward 3.7mm. Over the entire observation period (T3-T1), the overjet change was 3.8mm. The vertical measurements confirmed the forward and downward direction of growth in both maxilla and mandible. Conclusions: Significant overjet and molar relationship can be corrected using the Kiebach expansion appliance in conjunction with a facemask in young patients and the results were maintained 2 years after treatment.