Pre- and post-treatment cephalometric changes in adult patients with skeletal Class III malocclusion treated with orthodontic camouflage: a retrospective study
Abstract
Background. Class III malocclusion is a complex condition involving sagittal skeletal and dental discrepancies and is often associated with a concave facial profile. In selected adult patients, orthodontic camouflage represents a non-surgical treatment option aimed primarily at improving occlusion and facial relationships through dentoalveolar compensation. Objective. This study aimed to evaluate pre- and post-treatment cephalometric changes in adult patients with skeletal Class III malocclusion treated with orthodontic camouflage, focusing on skeletal, dental, and soft tissue parameters. Materials and methods. This retrospective observational study included 21 adult patients aged 18-27 years with skeletal Class III malocclusion who underwent orthodontic camouflage treatment without orthognathic surgery. Seventeen cephalometric parameters were evaluated on lateral cephalometric radiographs obtained before and after treatment. Pre- and post-treatment measurements were compared using paired-samples t-tests. Mean changes, 95% confidence intervals, and Cohen’s dz effect sizes were also calculated. Results. Statistically significant changes were observed in the U1-NA angle, U1-NA distance, L1-Nb angle, IMPA angle and interincisal angle (p < 0.05). The U1-NA angle increased following treatment, while the interincisal angle decreased, indicating changes in anterior tooth inclination and the interincisal relationship. The ANB angle showed a numerical movement toward a less negative value, but this change was not statistically significant. No statistically significant changes were observed in the other major skeletal parameters. The findings therefore suggest that the principal cephalometric changes were related to dentoalveolar compensation rather than demonstrated skeletal correction. Conclusion. Within the limitations of this retrospective study, orthodontic camouflage treatment was associated primarily with dental changes, particularly in U1-NA and interincisal angle. The findings support the role of dentoalveolar compensation in adult skeletal Class III treatment but do not demonstrate skeletal correction or prove treatment effectiveness.