{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:41:12Z","timestamp":1792248072344,"version":"4.4.0"},"reference-count":42,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize the phenotypes of skeletal Class III malocclusion in adult patients who underwent orthognathic surgery (OGS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>The sample consisted of 326 patients with Class III malocclusion treated with OGS (170 men and 156 women; mean age, 22.2 years). Using lateral cephalograms taken at initial visits, 13 angular variables and one ratio cephalometric variable were measured. Using three representative variables obtained from principal components analysis (SNA, SNB, and Bj\u00f6rk sum), K-means cluster analysis was performed to classify the phenotypes. Statistical analysis was conducted to characterize the differences in the cephalometric variables among the clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Class III phenotypes were classified into nine clusters from the following four major groups: (1) retrusive maxilla group, clusters 7 and 9 (7.1% and 5.5%; severely retrusive maxilla, normal mandible, severe and moderate hyperdivergent, respectively) and cluster 6 (9.2%; retrusive maxilla, normal mandible, normodivergent); (2) relatively protrusive mandible group, cluster 2 (20.9%; normal maxilla, normal mandible, hyperdivergent); (3) protrusive mandible group, clusters 3 and 1 (11.7% and 15.3%; normal maxilla, protrusive mandible, normodivergent and hyperdivergent, respectively) and clusters 8 and 4 (15.3% and 3.7%; normal maxilla, severe protrusive mandible, normodivergent and hypodivergent, respectively); and (4) protrusive maxilla and protrusive mandible group, cluster 5 (11.4%; protrusive maxilla, severely protrusive mandible, normodivergent). Considerations for presurgical orthodontic treatment and OGS planning were proposed based on the Class III phenotypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Because the anteroposterior position of the maxilla and rotation of the mandible by a patient's vertical pattern determine Class III phenotypes, these variables should be considered in diagnosis and treatment planning for patients who have skeletal Class III malocclusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/081421-635.1","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T10:01:07Z","timestamp":1644573667000},"page":"537-546","source":"Crossref","is-referenced-by-count":17,"title":["Characterization of phenotypes of skeletal Class III malocclusion in Korean adult patients treated with orthognathic surgery using cluster analysis"],"prefix":"10.2319","volume":"92","author":[{"given":"Il-Hyung","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Young","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Hak","family":"Baek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-92-4-537-b01","series-title":"Br J Orthod","first-page":"15","article-title":"Craniofacial form in Class III cases","volume":"19","author":"Mackay","year":"1992","unstructured":"Mackay\n              F,\n            \n            \n              Jones\n              JA,\n            \n            \n              Thompson\n              R,\n            \n            \n              Simpson\n              W.\n            \n          \n          Craniofacial form in Class III cases.\n\t\t\t\t\tBr J Orthod.\n\t\t\t\t\t1992;\n\t\t\t\t\t19:\n\t\t\t\t\t15\u2013\n\t\t\t\t\t20."},{"key":"i1945-7103-92-4-537-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"715","article-title":"Different skeletal types underlying Class III malocclusion in a random population","volume":"136","author":"Staudt","year":"2009","unstructured":"Staudt\n              CB,\n            \n            \n              Kiliaridis\n              S.\n            \n          \n          Different skeletal types underlying Class III malocclusion in a random population.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2009;\n\t\t\t\t\t136:\n\t\t\t\t\t715\u2013\n\t\t\t\t\t721."},{"key":"i1945-7103-92-4-537-b03","series-title":"Int J Oral Maxillofac Surg","first-page":"264","article-title":"A classification and characterization of skeletal Class III malocclusion on etiopathogenic basis","volume":"30","author":"Hong","year":"2001","unstructured":"Hong\n              SX,\n            \n            \n              Yi\n              CK.\n            \n          \n          A classification and characterization of skeletal Class III malocclusion on etiopathogenic basis.\n\t\t\t\t\tInt J Oral Maxillofac Surg.\n\t\t\t\t\t2001;\n\t\t\t\t\t30:\n\t\t\t\t\t264\u2013\n\t\t\t\t\t271."},{"key":"i1945-7103-92-4-537-b04","series-title":"Eur J Orthod","first-page":"599","article-title":"Growth prediction in Class III patients using cluster and discriminant function analysis","volume":"25","author":"Abu Alhaija","year":"2003","unstructured":"Abu Alhaija\n              ES,\n            \n            \n              Richardson\n              A.\n            \n          \n          Growth prediction in Class III patients using cluster and discriminant function analysis.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2003;\n\t\t\t\t\t25:\n\t\t\t\t\t599\u2013\n\t\t\t\t\t608."},{"key":"i1945-7103-92-4-537-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"32","article-title":"Phenotypic diversity in white adults with moderate to severe Class III malocclusion","volume":"144","author":"Moreno Uribe","year":"2013","unstructured":"Moreno Uribe\n              LM,\n            \n            \n              Vela\n              KC,\n            \n            \n              Kummet\n              C,\n            \n            \n              Dawson\n              DV,\n            \n            \n              Southard\n              TE.\n            \n          \n          Phenotypic diversity in white adults with moderate to severe Class III malocclusion.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2013;\n\t\t\t\t\t144:\n\t\t\t\t\t32\u2013\n\t\t\t\t\t42."},{"key":"i1945-7103-92-4-537-b06","series-title":"Eur J Orthod","first-page":"207","article-title":"Forecasting craniofacial growth in individuals with Class III malocclusion by computational modelling","volume":"36","author":"Auconi","year":"2014","unstructured":"Auconi\n              P,\n            \n            \n           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Rep","first-page":"17882","article-title":"Sub-clustering in skeletal Class III malocclusion phenotypes via principal component analysis in a southern European population","volume":"10","author":"de Frutos-Valle","year":"2020","unstructured":"de Frutos-Valle\n              L,\n            \n            \n              Martin\n              C,\n            \n            \n              Alarc\u00f3n\n              JA,\n            \n            \n              Palma-Fern\u00e1ndez\n              JC,\n            \n            \n              Ortega\n              R,\n            \n            \n              Iglesias-Linares\n              A.\n            \n          \n          Sub-clustering in skeletal Class III malocclusion phenotypes via principal component analysis in a southern European population.\n\t\t\t\t\tSci Rep.\n\t\t\t\t\t2020;\n\t\t\t\t\t10:\n\t\t\t\t\t17882."},{"key":"i1945-7103-92-4-537-b10","series-title":"J Clin Med","first-page":"3048","article-title":"Novel sub-clustering of Class III skeletal malocclusion phenotypes in a southern European population based on proportional measurements","volume":"9","author":"de Frutos-Valle","year":"2020","unstructured":"de Frutos-Valle\n              L,\n            \n            \n              Mart\u00edn\n              C,\n            \n            \n              Alarc\u00f3n\n              JA,\n            \n            \n              Palma-Fern\u00e1ndez\n              JC,\n            \n            \n              Ortega\n              R,\n            \n            \n              Iglesias-Linares\n              A.\n            \n          \n          Novel sub-clustering of Class III skeletal malocclusion phenotypes in a southern European population based on proportional measurements.\n\t\t\t\t\tJ Clin Med.\n\t\t\t\t\t2020;\n\t\t\t\t\t9:\n\t\t\t\t\t3048."},{"key":"i1945-7103-92-4-537-b11","series-title":"J Evid Based Dent Pract","first-page":"34","article-title":"Subclustering in skeletal Class III phenotypes of different ethnic origins: a systematic review","volume":"19","author":"de Frutos-Valle","year":"2019","unstructured":"de Frutos-Valle\n              L,\n            \n            \n              Martin\n              C,\n            \n            \n              Alarcon\n              JA,\n            \n            \n              Palma-Fernandez\n              JC,\n            \n            \n              Iglesias-Linares\n              A.\n            \n          \n          Subclustering in skeletal Class III phenotypes of different ethnic origins: a systematic review.\n\t\t\t\t\tJ Evid Based Dent Pract.\n\t\t\t\t\t2019;\n\t\t\t\t\t19:\n\t\t\t\t\t34\u2013\n\t\t\t\t\t52."},{"key":"i1945-7103-92-4-537-b12","series-title":"Korean J Orthod","first-page":"131","article-title":"A soft tissue analysis on facial esthetics of Korean young adults","volume":"21","author":"Baek","year":"1991","unstructured":"Baek\n              SH,\n            \n            \n              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\n            \n              Baek\n              SH.\n            \n          \n          Prognosis prediction for Class III malocclusion treatment by feature wrapping method.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2009;\n\t\t\t\t\t79:\n\t\t\t\t\t683\u2013\n\t\t\t\t\t691."},{"key":"i1945-7103-92-4-537-b15","series-title":"J Craniofac Surg","first-page":"2049","article-title":"Evaluation of treatment modality for skeletal Class III malocclusion with labioversed upper incisors and\/or protrusive maxilla: surgical movement and stability of rotational maxillary setback procedure","volume":"20","author":"Baek","year":"2009","unstructured":"Baek\n              SH,\n            \n            \n              Kim\n              K,\n            \n            \n              Choi\n              JY.\n            \n          \n          Evaluation of treatment modality for skeletal Class III malocclusion with labioversed upper incisors and\/or protrusive maxilla: surgical movement and stability of rotational maxillary setback procedure.\n\t\t\t\t\tJ Craniofac Surg.\n\t\t\t\t\t2009;\n\t\t\t\t\t20:\n\t\t\t\t\t2049\u2013\n\t\t\t\t\t2054."},{"key":"i1945-7103-92-4-537-b16","series-title":"Am J Orthod Dentofacial Orthop","first-page":"324","article-title":"Change in maxillary incisor inclination during surgical-orthodontic treatment of skeletal Class III malocclusion: comparison of extraction and nonextraction of the maxillary first premolars","volume":"143","author":"Kim","year":"2013","unstructured":"Kim\n              DK,\n            \n            \n              Baek\n              SH.\n            \n          \n          Change in maxillary incisor inclination during surgical-orthodontic treatment of skeletal Class III malocclusion: comparison of extraction and nonextraction of the maxillary first premolars.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2013;\n\t\t\t\t\t143:\n\t\t\t\t\t324\u2013\n\t\t\t\t\t335."},{"key":"i1945-7103-92-4-537-b17","series-title":"Angle 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type effects on lower incisor preoperative decompensation and postoperative compensation in skeletal Class III patients","volume":"81","author":"Ahn","year":"2011","unstructured":"Ahn\n              HW,\n            \n            \n              Baek\n              SH.\n            \n          \n          Skeletal anteroposterior discrepancy and vertical type effects on lower incisor preoperative decompensation and postoperative compensation in skeletal Class III patients.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2011;\n\t\t\t\t\t81:\n\t\t\t\t\t64\u2013\n\t\t\t\t\t74."},{"key":"i1945-7103-92-4-537-b19","series-title":"J Clin Med","first-page":"2870","article-title":"Effects of presurgical mandibular incisor decompensation on long-term outcomes of Class III surgical orthodontic treatment","volume":"19","author":"An","year":"2021","unstructured":"An\n              JS,\n            \n            \n              Jeong\n              W,\n            \n            \n              Sonnesen\n              L,\n            \n            \n              Baek\n              SH,\n            \n            \n              Ahn\n              SJ.\n            \n          \n          Effects of presurgical mandibular incisor decompensation on long-term outcomes of Class III surgical orthodontic treatment.\n\t\t\t\t\tJ Clin Med.\n\t\t\t\t\t2021;\n\t\t\t\t\t19:\n\t\t\t\t\t2870."},{"key":"i1945-7103-92-4-537-b20","series-title":"J Craniofac Surg","first-page":"586","article-title":"Assessment of the relationships among posture, maxillomandibular denture complex, and soft-tissue profile of aesthetic adult Korean women","volume":"11","author":"Choi","year":"2000","unstructured":"Choi\n              B,\n            \n            \n              Baek\n              SH,\n            \n            \n              Yang\n              WS,\n            \n            \n              Kim\n              S.\n            \n          \n          Assessment of the relationships among posture, maxillomandibular denture complex, and soft-tissue profile of aesthetic adult Korean women.\n\t\t\t\t\tJ Craniofac Surg.\n\t\t\t\t\t2000;\n\t\t\t\t\t11:\n\t\t\t\t\t586\u2013\n\t\t\t\t\t594."},{"key":"i1945-7103-92-4-537-b21","series-title":"J Craniofac Surg","first-page":"1708","article-title":"Establishing the customized occlusal plane in systemized surgical treatment objectives of Class III","volume":"22","author":"Baek","year":"2011","unstructured":"Baek\n              SH,\n            \n            \n              Ahn\n              HW,\n            \n            \n              Yang\n              SD,\n            \n            \n              Choi\n              JY.\n            \n          \n          Establishing the customized occlusal plane in systemized surgical treatment objectives of Class III.\n\t\t\t\t\tJ Craniofac Surg.\n\t\t\t\t\t2011;\n\t\t\t\t\t22:\n\t\t\t\t\t1708\u2013\n\t\t\t\t\t1713."},{"key":"i1945-7103-92-4-537-b01","series-title":"Br J Orthod","first-page":"15","article-title":"Craniofacial form in Class III cases","volume":"19","author":"Mackay","year":"1992","unstructured":"Mackay\n              F,\n            \n            \n              Jones\n              JA,\n            \n            \n              Thompson\n              R,\n            \n            \n              Simpson\n              W.\n            \n          \n          Craniofacial form in Class III cases.\n\t\t\t\t\tBr J Orthod.\n\t\t\t\t\t1992;\n\t\t\t\t\t19:\n\t\t\t\t\t15\u2013\n\t\t\t\t\t20."},{"key":"i1945-7103-92-4-537-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"715","article-title":"Different skeletal types underlying Class III malocclusion in a random population","volume":"136","author":"Staudt","year":"2009","unstructured":"Staudt\n              CB,\n            \n            \n              Kiliaridis\n              S.\n            \n          \n          Different skeletal types underlying Class III malocclusion in a random population.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2009;\n\t\t\t\t\t136:\n\t\t\t\t\t715\u2013\n\t\t\t\t\t721."},{"key":"i1945-7103-92-4-537-b03","series-title":"Int J Oral Maxillofac Surg","first-page":"264","article-title":"A classification and characterization of skeletal Class III malocclusion on etiopathogenic basis","volume":"30","author":"Hong","year":"2001","unstructured":"Hong\n              SX,\n            \n            \n              Yi\n              CK.\n            \n          \n          A classification and characterization of skeletal Class III malocclusion on etiopathogenic basis.\n\t\t\t\t\tInt J Oral Maxillofac Surg.\n\t\t\t\t\t2001;\n\t\t\t\t\t30:\n\t\t\t\t\t264\u2013\n\t\t\t\t\t271."},{"key":"i1945-7103-92-4-537-b04","series-title":"Eur J Orthod","first-page":"599","article-title":"Growth prediction in Class III patients using cluster and discriminant function analysis","volume":"25","author":"Abu Alhaija","year":"2003","unstructured":"Abu Alhaija\n              ES,\n            \n            \n              Richardson\n              A.\n            \n          \n          Growth prediction in Class III patients using cluster and discriminant function analysis.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2003;\n\t\t\t\t\t25:\n\t\t\t\t\t599\u2013\n\t\t\t\t\t608."},{"key":"i1945-7103-92-4-537-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"32","article-title":"Phenotypic diversity in white adults with moderate to severe Class III malocclusion","volume":"144","author":"Moreno Uribe","year":"2013","unstructured":"Moreno Uribe\n              LM,\n            \n            \n              Vela\n              KC,\n            \n            \n              Kummet\n              C,\n            \n            \n              Dawson\n              DV,\n            \n            \n              Southard\n              TE.\n            \n          \n          Phenotypic diversity in white adults with moderate to severe Class III malocclusion.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2013;\n\t\t\t\t\t144:\n\t\t\t\t\t32\u2013\n\t\t\t\t\t42."},{"key":"i1945-7103-92-4-537-b06","series-title":"Eur J Orthod","first-page":"207","article-title":"Forecasting craniofacial growth in individuals with Class III malocclusion by computational modelling","volume":"36","author":"Auconi","year":"2014","unstructured":"Auconi\n              P,\n            \n            \n              Scazzocchio\n              M,\n            \n            \n              Defraia\n              E,\n            \n            \n              McNamara\n              JA,\n            \n            \n              Franchi\n              L.\n            \n          \n          Forecasting craniofacial growth in individuals with Class III malocclusion by computational modelling.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2014;\n\t\t\t\t\t36:\n\t\t\t\t\t207\u2013\n\t\t\t\t\t216."},{"key":"i1945-7103-92-4-537-b07","series-title":"Eur J Orthod","first-page":"257","article-title":"Prediction of Class III treatment outcomes through orthodontic data mining","volume":"37","author":"Auconi","year":"2015","unstructured":"Auconi\n              P,\n            \n            \n              Scazzocchio\n              M,\n            \n            \n              Cozza\n              P,\n            \n            \n              McNamara\n              JA\n              Jr,\n            \n            \n              Franchi\n              L.\n            \n          \n          Prediction of Class III treatment outcomes through orthodontic data mining.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2015;\n\t\t\t\t\t37:\n\t\t\t\t\t257\u2013\n\t\t\t\t\t267."},{"key":"i1945-7103-92-4-537-b08","series-title":"Head Face Med","first-page":"31","article-title":"Classification and characterization of Class III malocclusion in Chinese individuals","volume":"12","author":"Li","year":"2016","unstructured":"Li\n              C,\n            \n            \n              Cai\n              Y,\n            \n            \n              Chen\n              S,\n            \n            \n              Chen\n              F.\n            \n          \n          Classification and characterization of Class III malocclusion in Chinese individuals.\n\t\t\t\t\tHead Face Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t12:\n\t\t\t\t\t31."},{"key":"i1945-7103-92-4-537-b09","series-title":"Sci Rep","first-page":"17882","article-title":"Sub-clustering in skeletal Class III malocclusion phenotypes via principal component analysis in a southern European population","volume":"10","author":"de Frutos-Valle","year":"2020","unstructured":"de Frutos-Valle\n              L,\n            \n            \n              Martin\n              C,\n            \n            \n              Alarc\u00f3n\n              JA,\n            \n            \n              Palma-Fern\u00e1ndez\n              JC,\n            \n            \n              Ortega\n              R,\n            \n            \n              Iglesias-Linares\n              A.\n            \n          \n          Sub-clustering in skeletal Class III malocclusion phenotypes via principal component analysis in a southern European population.\n\t\t\t\t\tSci Rep.\n\t\t\t\t\t2020;\n\t\t\t\t\t10:\n\t\t\t\t\t17882."},{"key":"i1945-7103-92-4-537-b10","series-title":"J Clin Med","first-page":"3048","article-title":"Novel sub-clustering of Class III skeletal malocclusion phenotypes in a southern European population based on proportional measurements","volume":"9","author":"de Frutos-Valle","year":"2020","unstructured":"de Frutos-Valle\n              L,\n            \n            \n              Mart\u00edn\n              C,\n            \n            \n              Alarc\u00f3n\n              JA,\n            \n            \n              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           Cephalometric Analysis of Normal Occlusion in Korean Adults\n          .\n\t\t\t\t\tKorean Association of Orthodontists;1997, Seoul, South Korea."},{"key":"i1945-7103-92-4-537-b14","series-title":"Angle Orthod","first-page":"683","article-title":"Prognosis prediction for Class III malocclusion treatment by feature wrapping method","volume":"79","author":"Kim","year":"2009","unstructured":"Kim\n              BM,\n            \n            \n              Kang\n              BY,\n            \n            \n              Kim\n              HG,\n            \n            \n              Baek\n              SH.\n            \n          \n          Prognosis prediction for Class III malocclusion treatment by feature wrapping method.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2009;\n\t\t\t\t\t79:\n\t\t\t\t\t683\u2013\n\t\t\t\t\t691."},{"key":"i1945-7103-92-4-537-b15","series-title":"J Craniofac Surg","first-page":"2049","article-title":"Evaluation of treatment modality for skeletal Class 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maxillary first premolars","volume":"143","author":"Kim","year":"2013","unstructured":"Kim\n              DK,\n            \n            \n              Baek\n              SH.\n            \n          \n          Change in maxillary incisor inclination during surgical-orthodontic treatment of skeletal Class III malocclusion: comparison of extraction and nonextraction of the maxillary first premolars.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2013;\n\t\t\t\t\t143:\n\t\t\t\t\t324\u2013\n\t\t\t\t\t335."},{"key":"i1945-7103-92-4-537-b17","series-title":"Angle Orthod","first-page":"720","article-title":"Maxillary incisor inclination of skeletal Class III patients treated with extraction of the upper first premolars and two-jaw surgery: conventional orthognathic surgery vs surgery-first approach","volume":"84","author":"Park","year":"2014","unstructured":"Park\n              HM,\n            \n            \n              Lee\n              YK,\n            \n            \n       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plane in systemized surgical treatment objectives of Class III","volume":"22","author":"Baek","year":"2011","unstructured":"Baek\n              SH,\n            \n            \n              Ahn\n              HW,\n            \n            \n              Yang\n              SD,\n            \n            \n              Choi\n              JY.\n            \n          \n          Establishing the customized occlusal plane in systemized surgical treatment objectives of Class III.\n\t\t\t\t\tJ Craniofac Surg.\n\t\t\t\t\t2011;\n\t\t\t\t\t22:\n\t\t\t\t\t1708\u2013\n\t\t\t\t\t1713."}],"container-title":["The Angle 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