{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:54:48Z","timestamp":1791575688063,"version":"4.3.4"},"reference-count":34,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study investigated the long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion and different vertical skeletal patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A total of 54 patients (20 boys and 34 girls; mean age, 7.7 \u00b1 2.0 years) with Class III malocclusion who were successfully treated with facemask therapy were included in this study. Vertical skeletal changes (overbite depth indicator, angle between the Sella-Nasion (SN) plane and Gonion-Gnathion (GoGn) line, angle between the Frankfort horizontal (FH) plane and mandibular plane, gonial angle, and angle between the SN plane and palatal plane) were measured on lateral cephalograms from before treatment (T0) to after facemask therapy (T1) and from T0 to after retention (T2). Multivariate linear regression analysis was used to study the associations of the patients' skeletal patterns with the short-term (T0\u2013T1) and long-term (T0\u2013T2) vertical skeletal changes as a result of facemask therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean treatment period of facemask therapy (T0\u2013T1) was 1.4 \u00b1 0.6 years, and the mean retention period (T1\u2013T2) was 6.9 \u00b1 2.6 years. Age at T0 was significantly correlated with vertical skeletal changes from T0 to T1. Differences in the treatment results between sexes were not significant. The angle between point A-point B line and mandibular plane to mandibular plane angle at T0 and the angle between the FH plane and mandibular plane at T0 were significant predictors for short-term and long-term changes. Changes in the Sella-Nasion-point A from T0 to T1 and from T1 to T2 significantly affected vertical changes in the short term and long term, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Vertical skeletal changes as a result of facemask therapy are significantly associated with severity of the skeletal Class III malocclusion and mandibular plane angulation before treatment and the amount of forward maxillary growth during the treatment and retention periods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/042717-282.1","type":"journal-article","created":{"date-parts":[[2017,11,13]],"date-time":"2017-11-13T13:43:35Z","timestamp":1510580615000},"page":"157-162","source":"Crossref","is-referenced-by-count":11,"title":["Factors associated with long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion"],"prefix":"10.2319","volume":"88","author":[{"given":"Hee-Jong","family":"Kwak","sequence":"first","affiliation":[{"name":"Student, Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae-Jin","family":"Park","sequence":"additional","affiliation":[{"name":"Student, Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon-Ji","family":"Kim","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Orthodontics, Korea University Anam Hospital, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Yul","family":"Lee","sequence":"additional","affiliation":[{"name":"Professor and Chair, Department of Orthodontics, Korea University Guro Hospital, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-88-2-157-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"13","article-title":"Cephalometric changes after the correction of class III malocclusion with maxillary expansion\/facemask therapy","volume":"116","author":"Macdonald \n              KE.","year":"1999","unstructured":"Macdonald \n              KE.\n            \n            \n              Kapust \n              AJ.\n            \n            \n              Turley \n              PK.\n            \n          \n          Cephalometric changes after the correction of class III malocclusion with maxillary expansion\/facemask therapy. Am J Orthod Dentofacial Orthop. 1999;116:13\u201324."},{"key":"i0003-3219-88-2-157-b02","series-title":"Eur J Orthod","first-page":"237","article-title":"Cephalometric and occlusal changes following maxillary expansion and protraction","volume":"20","author":"Ngan \n              P.","year":"1998","unstructured":"Ngan \n              P.\n            \n            \n              Yiu \n              C.\n            \n            \n              Hu \n              A.\n            \n            \n              Hagg \n              U.\n            \n            \n              Wei \n              SH.\n            \n            \n              Gunel \n              E.\n            \n          \n          Cephalometric and occlusal changes following maxillary expansion and protraction. Eur J Orthod. 1998;20:237\u2013254."},{"key":"i0003-3219-88-2-157-b03","series-title":"Semin Orthod","first-page":"143","article-title":"Treatment of the class III malocclusion with maxillary expansion and protraction","volume":"13","author":"Turley \n              PK.","year":"2007","unstructured":"Turley \n              PK.\n            \n          \n          Treatment of the class III malocclusion with maxillary expansion and protraction. Semin Orthod. 2007;13:143\u2013157."},{"key":"i0003-3219-88-2-157-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"299","article-title":"The effects of maxillary protraction therapy with or without rapid palatal expansion: a prospective, randomized clinical trial","volume":"128","author":"Vaughn \n              GA.","year":"2005","unstructured":"Vaughn \n              GA.\n            \n            \n              Mason \n              B.\n            \n            \n              Moon \n              HB.\n            \n            \n              Turley \n              PK.\n            \n          \n          The effects of maxillary protraction therapy with or without rapid palatal expansion: a prospective, randomized clinical trial. Am J Orthod Dentofacial Orthop. 2005;128:299\u2013309."},{"key":"i0003-3219-88-2-157-b05","series-title":"Angle Orthod","first-page":"349","article-title":"Very early face mask therapy in class III children","volume":"69","author":"Deguchi \n              T.","year":"1999","unstructured":"Deguchi \n              T.\n            \n            \n              Kanomi \n              R.\n            \n            \n              Ashizawa \n              Y.\n            \n            \n              Rosenstein \n              SW.\n            \n          \n          Very early face mask therapy in class III children. Angle Orthod. 1999;69:349\u2013355."},{"key":"i0003-3219-88-2-157-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"23","article-title":"Comparison of orthodontic and orthopedic effects of a modified maxillary protractor between deciduous and early mixed dentitions","volume":"126","author":"Kajiyama \n              K.","year":"2004","unstructured":"Kajiyama \n              K.\n            \n            \n              Murakami \n              T.\n            \n            \n              Suzuki \n              A.\n            \n          \n          Comparison of orthodontic and orthopedic effects of a modified maxillary protractor between deciduous and early mixed dentitions. Am J Orthod Dentofacial Orthop. 2004;126:23\u201332."},{"key":"i0003-3219-88-2-157-b07","series-title":"Orthod Craniofac Res","first-page":"133","article-title":"Efficacy of orthopedic treatment with protraction facemask on skeletal class III malocclusion: a systematic review and meta-analysis","volume":"17","author":"Cordasco \n              G.","year":"2014","unstructured":"Cordasco \n              G.\n            \n            \n              Matarese \n              G.\n            \n            \n              Rustico \n              L.\n            \n            et al. \n          Efficacy of orthopedic treatment with protraction facemask on skeletal class III malocclusion: a systematic review and meta-analysis. Orthod Craniofac Res. 2014;17:133\u2013143."},{"key":"i0003-3219-88-2-157-b08","series-title":"Contemporary Orthodontics. 5th ed","first-page":"502","author":"Proffit \n              WR.","year":"2014","unstructured":"Proffit \n              WR.\n            \n            \n              Fields \n              HW\n              Jr, \n            \n            \n              Sarver \n              DM.\n            \n          \n          Contemporary Orthodontics. 5th ed. St. Louis: Elsevier Health Sciences;2014:502\u2013510."},{"key":"i0003-3219-88-2-157-b09","series-title":"Eur J Orthod","first-page":"126","article-title":"Effects of treatment with a combined maxillary protraction and chincap appliance in skeletal class III patients with different vertical skeletal morphologies","volume":"29","author":"Yoshida \n              I.","year":"2007","unstructured":"Yoshida \n              I.\n            \n            \n              Shoji \n              T.\n            \n            \n              Mizoguchi \n              I.\n            \n          \n          Effects of treatment with a combined maxillary protraction and chincap appliance in skeletal class III patients with different vertical skeletal morphologies. Eur J Orthod. 2007;29:126\u2013133."},{"key":"i0003-3219-88-2-157-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"16","article-title":"Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy","volume":"126","author":"Baccetti \n              T.","year":"2004","unstructured":"Baccetti \n              T.\n            \n            \n              Franchi \n              L.\n            \n            \n              McNamara \n              JA\n              Jr. \n            \n          \n          Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop. 2004;126:16\u201322."},{"key":"i0003-3219-88-2-157-b11","series-title":"Angle Orthod","first-page":"927","article-title":"Short-term effects produced by rapid maxillary expansion and facemask therapy in class III patients with different vertical skeletal relationships","volume":"85","author":"Pavoni \n              C.","year":"2015","unstructured":"Pavoni \n              C.\n            \n            \n              Masucci \n              C.\n            \n            \n              Cerroni \n              S.\n            \n            \n              Franchi \n              L.\n            \n            \n              Cozza \n              P.\n            \n          \n          Short-term effects produced by rapid maxillary expansion and facemask therapy in class III patients with different vertical skeletal relationships. Angle Orthod. 2015;85:927\u2013933."},{"key":"i0003-3219-88-2-157-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"301","article-title":"Cephalometric variables to predict future success of early orthopedic Class III treatment","volume":"127","author":"Ghiz \n              MA.","year":"2005","unstructured":"Ghiz \n              MA.\n            \n            \n              Ngan \n              P.\n            \n            \n              Gunel \n              E.\n            \n          \n          Cephalometric variables to predict future success of early orthopedic Class III treatment. Am J Orthod Dentofacial Orthop. 2005;127:301\u2013306."},{"key":"i0003-3219-88-2-157-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"681","article-title":"Craniofacial morphology in orthodontically treated patients of class III malocclusion with stable and unstable treatment outcomes","volume":"117","author":"Tahmina \n              K.","year":"2000","unstructured":"Tahmina \n              K.\n            \n            \n              Tanaka \n              E.\n            \n            \n              Tanne \n              K.\n            \n          \n          Craniofacial morphology in orthodontically treated patients of class III malocclusion with stable and unstable treatment outcomes. Am J Orthod Dentofacial Orthop. 2000;117:681\u2013690."},{"key":"i0003-3219-88-2-157-b14","series-title":"Eur J Orthod","first-page":"190","article-title":"Prediction of the outcome of orthodontic treatment of class III malocclusions\u2014a systematic review","volume":"33","author":"Fudalej \n              P.","year":"2011","unstructured":"Fudalej \n              P.\n            \n            \n              Dragan \n              M.\n            \n            \n              Wedrychowska-Szulc \n              B.\n            \n          \n          Prediction of the outcome of orthodontic treatment of class III malocclusions\u2014a systematic review. Eur J Orthod. 2011;33:190\u2013197."},{"key":"i0003-3219-88-2-157-b15","series-title":"Angle Orthod","first-page":"747","article-title":"Cephalometric predictors of long-term stability in the early treatment of class III malocclusion","volume":"75","author":"Moon \n              YM.","year":"2005","unstructured":"Moon \n              YM.\n            \n            \n              Ahn \n              SJ.\n            \n            \n              Chang \n              YI.\n            \n          \n          Cephalometric predictors of long-term stability in the early treatment of class III malocclusion. Angle Orthod. 2005;75:747\u2013753."},{"key":"i0003-3219-88-2-157-b16","series-title":"Eur J Orthod","first-page":"559","article-title":"Early and late facemask therapy","volume":"23","author":"Yuksel \n              S.","year":"2001","unstructured":"Yuksel \n              S.\n            \n            \n              Ucem \n              TT.\n            \n            \n              Keykubat \n              A.\n            \n          \n          Early and late facemask therapy. Eur J Orthod. 2001;23:559\u2013568."},{"key":"i0003-3219-88-2-157-b17","series-title":"Am J Orthod Dentofacial Orthop","first-page":"300","article-title":"Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in class III malocclusion","volume":"138","author":"Cozza \n              P.","year":"2010","unstructured":"Cozza \n              P.\n            \n            \n              Baccetti \n              T.\n            \n            \n              Mucedero \n              M.\n            \n            \n              Pavoni \n              C.\n            \n            \n              Franchi \n              L.\n            \n          \n          Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in class III malocclusion. Am J Orthod Dentofacial Orthop. 2010;138:300\u2013310."},{"key":"i0003-3219-88-2-157-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"13","article-title":"Cephalometric changes after the correction of class III malocclusion with maxillary expansion\/facemask therapy","volume":"116","author":"Macdonald \n              KE.","year":"1999","unstructured":"Macdonald \n              KE.\n            \n            \n              Kapust \n              AJ.\n            \n            \n              Turley \n              PK.\n            \n          \n          Cephalometric changes after the correction of class III malocclusion with maxillary expansion\/facemask therapy. Am J Orthod Dentofacial Orthop. 1999;116:13\u201324."},{"key":"i0003-3219-88-2-157-b02","series-title":"Eur J Orthod","first-page":"237","article-title":"Cephalometric and occlusal changes following maxillary expansion and protraction","volume":"20","author":"Ngan \n              P.","year":"1998","unstructured":"Ngan \n              P.\n            \n            \n              Yiu \n              C.\n            \n            \n              Hu \n              A.\n            \n            \n              Hagg \n              U.\n            \n            \n              Wei \n              SH.\n            \n            \n              Gunel \n              E.\n            \n          \n          Cephalometric and occlusal changes following maxillary expansion and protraction. Eur J Orthod. 1998;20:237\u2013254."},{"key":"i0003-3219-88-2-157-b03","series-title":"Semin Orthod","first-page":"143","article-title":"Treatment of the class III malocclusion with maxillary expansion and protraction","volume":"13","author":"Turley \n              PK.","year":"2007","unstructured":"Turley \n              PK.\n            \n          \n          Treatment of the class III malocclusion with maxillary expansion and protraction. Semin Orthod. 2007;13:143\u2013157."},{"key":"i0003-3219-88-2-157-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"299","article-title":"The effects of maxillary protraction therapy with or without rapid palatal expansion: a prospective, randomized clinical trial","volume":"128","author":"Vaughn \n              GA.","year":"2005","unstructured":"Vaughn \n              GA.\n            \n            \n              Mason \n              B.\n            \n            \n              Moon \n              HB.\n            \n            \n              Turley \n              PK.\n            \n          \n          The effects of maxillary protraction therapy with or without rapid palatal expansion: a prospective, randomized clinical trial. Am J Orthod Dentofacial Orthop. 2005;128:299\u2013309."},{"key":"i0003-3219-88-2-157-b05","series-title":"Angle Orthod","first-page":"349","article-title":"Very early face mask therapy in class III children","volume":"69","author":"Deguchi \n              T.","year":"1999","unstructured":"Deguchi \n              T.\n            \n            \n              Kanomi \n              R.\n            \n            \n              Ashizawa \n              Y.\n            \n            \n              Rosenstein \n              SW.\n            \n          \n          Very early face mask therapy in class III children. Angle Orthod. 1999;69:349\u2013355."},{"key":"i0003-3219-88-2-157-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"23","article-title":"Comparison of orthodontic and orthopedic effects of a modified maxillary protractor between deciduous and early mixed dentitions","volume":"126","author":"Kajiyama \n              K.","year":"2004","unstructured":"Kajiyama \n              K.\n            \n            \n              Murakami \n              T.\n            \n            \n              Suzuki \n              A.\n            \n          \n          Comparison of orthodontic and orthopedic effects of a modified maxillary protractor between deciduous and early mixed dentitions. Am J Orthod Dentofacial Orthop. 2004;126:23\u201332."},{"key":"i0003-3219-88-2-157-b07","series-title":"Orthod Craniofac Res","first-page":"133","article-title":"Efficacy of orthopedic treatment with protraction facemask on skeletal class III malocclusion: a systematic review and meta-analysis","volume":"17","author":"Cordasco \n              G.","year":"2014","unstructured":"Cordasco \n              G.\n            \n            \n              Matarese \n              G.\n            \n            \n              Rustico \n              L.\n            \n            et al. \n          Efficacy of orthopedic treatment with protraction facemask on skeletal class III malocclusion: a systematic review and meta-analysis. Orthod Craniofac Res. 2014;17:133\u2013143."},{"key":"i0003-3219-88-2-157-b08","series-title":"Contemporary Orthodontics. 5th ed","first-page":"502","author":"Proffit \n              WR.","year":"2014","unstructured":"Proffit \n              WR.\n            \n            \n              Fields \n              HW\n              Jr, \n            \n            \n              Sarver \n              DM.\n            \n          \n          Contemporary Orthodontics. 5th ed. St. Louis: Elsevier Health Sciences;2014:502\u2013510."},{"key":"i0003-3219-88-2-157-b09","series-title":"Eur J Orthod","first-page":"126","article-title":"Effects of treatment with a combined maxillary protraction and chincap appliance in skeletal class III patients with different vertical skeletal morphologies","volume":"29","author":"Yoshida \n              I.","year":"2007","unstructured":"Yoshida \n              I.\n            \n            \n              Shoji \n              T.\n            \n            \n              Mizoguchi \n              I.\n            \n          \n          Effects of treatment with a combined maxillary protraction and chincap appliance in skeletal class III patients with different vertical skeletal morphologies. Eur J Orthod. 2007;29:126\u2013133."},{"key":"i0003-3219-88-2-157-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"16","article-title":"Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy","volume":"126","author":"Baccetti \n              T.","year":"2004","unstructured":"Baccetti \n              T.\n            \n            \n              Franchi \n              L.\n            \n            \n              McNamara \n              JA\n              Jr. \n            \n          \n          Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop. 2004;126:16\u201322."},{"key":"i0003-3219-88-2-157-b11","series-title":"Angle Orthod","first-page":"927","article-title":"Short-term effects produced by rapid maxillary expansion and facemask therapy in class III patients with different vertical skeletal relationships","volume":"85","author":"Pavoni \n              C.","year":"2015","unstructured":"Pavoni \n              C.\n            \n            \n              Masucci \n              C.\n            \n            \n              Cerroni \n              S.\n            \n            \n              Franchi \n              L.\n            \n            \n              Cozza \n              P.\n            \n          \n          Short-term effects produced by rapid maxillary expansion and facemask therapy in class III patients with different vertical skeletal relationships. Angle Orthod. 2015;85:927\u2013933."},{"key":"i0003-3219-88-2-157-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"301","article-title":"Cephalometric variables to predict future success of early orthopedic Class III treatment","volume":"127","author":"Ghiz \n              MA.","year":"2005","unstructured":"Ghiz \n              MA.\n            \n            \n              Ngan \n              P.\n            \n            \n              Gunel \n              E.\n            \n          \n          Cephalometric variables to predict future success of early orthopedic Class III treatment. Am J Orthod Dentofacial Orthop. 2005;127:301\u2013306."},{"key":"i0003-3219-88-2-157-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"681","article-title":"Craniofacial morphology in orthodontically treated patients of class III malocclusion with stable and unstable treatment outcomes","volume":"117","author":"Tahmina \n              K.","year":"2000","unstructured":"Tahmina \n              K.\n            \n            \n              Tanaka \n              E.\n            \n            \n              Tanne \n              K.\n            \n          \n          Craniofacial morphology in orthodontically treated patients of class III malocclusion with stable and unstable treatment outcomes. Am J Orthod Dentofacial Orthop. 2000;117:681\u2013690."},{"key":"i0003-3219-88-2-157-b14","series-title":"Eur J Orthod","first-page":"190","article-title":"Prediction of the outcome of orthodontic treatment of class III malocclusions\u2014a systematic review","volume":"33","author":"Fudalej \n              P.","year":"2011","unstructured":"Fudalej \n              P.\n            \n            \n              Dragan \n              M.\n            \n            \n              Wedrychowska-Szulc \n              B.\n            \n          \n          Prediction of the outcome of orthodontic treatment of class III malocclusions\u2014a systematic review. Eur J Orthod. 2011;33:190\u2013197."},{"key":"i0003-3219-88-2-157-b15","series-title":"Angle Orthod","first-page":"747","article-title":"Cephalometric predictors of long-term stability in the early treatment of class III malocclusion","volume":"75","author":"Moon \n              YM.","year":"2005","unstructured":"Moon \n              YM.\n            \n            \n              Ahn \n              SJ.\n            \n            \n              Chang \n              YI.\n            \n          \n          Cephalometric predictors of long-term stability in the early treatment of class III malocclusion. Angle Orthod. 2005;75:747\u2013753."},{"key":"i0003-3219-88-2-157-b16","series-title":"Eur J Orthod","first-page":"559","article-title":"Early and late facemask therapy","volume":"23","author":"Yuksel \n              S.","year":"2001","unstructured":"Yuksel \n              S.\n            \n            \n              Ucem \n              TT.\n            \n            \n              Keykubat \n              A.\n            \n          \n          Early and late facemask therapy. Eur J Orthod. 2001;23:559\u2013568."},{"key":"i0003-3219-88-2-157-b17","series-title":"Am J Orthod Dentofacial Orthop","first-page":"300","article-title":"Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in class III malocclusion","volume":"138","author":"Cozza \n              P.","year":"2010","unstructured":"Cozza \n              P.\n            \n            \n              Baccetti \n              T.\n            \n            \n              Mucedero \n              M.\n            \n            \n              Pavoni \n              C.\n            \n            \n              Franchi \n              L.\n            \n          \n          Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in class III malocclusion. 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