Ortho-surgical treatment of maxillary in Class III patients with severe mandibular protrusion and middle line deviation: a systematic review

Introduction: In Brazil, malocclusion is found in ages between 7 and 15 years 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 its strong aesthetic compromise and unfavorable treatment prognosis, especially when there is a hereditary component. It is suggested that most cases of Class III malocclusion have maxillary retrusion or hypoplasia, which may or may not be associated with mandibular prognathism. Thus, several treatment modalities are proposed for the correction of Class III malocclusion. Objective: To explore the literary findings of the importance of knowing advances in orthodontics for the treatment of class III malocclusion. Methods: Experimental and clinical studies (case reports, retrospective, prospective and randomized) with qualitative and/or quantitative analysis were included, following the rules of the systematic review-PRISMA. 289 articles were initially found and, after selection, 54 articles were used to compose this study. Results and conclusion: According to the literary findings, the treatment of Class III should be fundamentally based on the diagnosis so that the treatment can be 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 must be evaluated so that the treatment is directed to that bone base and really achieves its goals and impacts of facial improvement. Redirection of growth in Class III cases is indicated as soon as the anomaly is diagnosed, as the displacement processes that occur in the middle face can only be affected with treatment while the growth zones are able to respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects