Evaluation of the need for orthognathic surgery in skeletal class III individuals treated with early face mask

Aim: The aim of this study is to determine whether the face mask treatment applied in the early period reduces the need for orthognathic surgery after growth and development and to evaluate the changes in skeletal, dental and soft tissue structures and long-term post-treatment results. Material and Methods: Twenty-two patients (9 girls, 13 boys) with a mean age of 20.16 ± 1.67 years who were treated with face masks during growth and development period were included in the study. Lateral cephalometric radiographs of individuals before treatment (T0), after face mask application (T1) and after long-term follow-up (T2) were evaluated. Intraoral and extraoral photographs, dental casts, panoramic, lateral cephalometric and anteroposterior radiographs taken during the follow-up records were evaluated by 3 senior clinicians and the need for orthognathic surgery was decided. According to this decision, individuals were divided into two subgroups with and without surgical need and compared. Results: Forward movement occurred in the maxilla with the face mask, and this change remained stable during the long follow-up period. While no change was observed in the mandible with treatment, long-term growth was observed. ANB angle and overjet improved with face mask, but the change in overjet amount remained relatively stable in the long term, while the change in ANB angle could not be maintained. In the upper incisors, proclination was observed with the effect of face mask and the effect of fixed treatment in the follow-up period. Retroclination was observed in the lower incisors during the treatment process, and they almost returned to their initial positions during the follow-up period. It was determined that 27.27% of the individuals included in the study needed orthognathic surgery. A significant difference was found between the subgroups with and without surgical need in terms of initial gonial angle, SNB angle and IMPA angle. Conclusion: It has been observed that face mask treatment significantly reduces the need for orthognathic surgery, and the results obtained with the treatment are mostly preserved in the follow-up period.