Long-term effect of the chincap on hard and soft tissues

Abstract

The short- and long-term effects of the chincap used in combination with a removable appliance to procline upper incisors were analysed cephalometrically in 23 patients with Class III malocclusions. The overall changes were compared with growth changes in a closely matched control sample of untreated Class III patients. There was no evidence that the chincap retarded growth of the mandible. During treatment, there was an increase in mandibular length and facial height. The lower incisors retroclined and the upper incisors proclined. The incisor relationship was corrected. Soft tissue changes included an increase in nasolabial angle and improvement in soft-tissue profile, including the nose. Skeletal post-treatment changes included further mandibular growth associated with an increase in angle SNB and Wits measurement. Facial height also increased significantly. The Class I overjet was maintained, although slightly diminished. The soft tissue nose, upper and lower lip, and chin moved anteriorly, and the nasal tip and chin moved inferiorly. At the end of the study period there were no significant skeletal or soft tissue differences between the treated and control groups. The only significant contrasts were in the overjet and the overbite. Chincap therapy combined with an upper removable appliance to procline the upper incisors is effective in producing long-term correction of the incisor relationship by retro-clination of lower incisors, proclination of upper incisors, and redirection of mandibular growth in a downward direction. The direction of growth at the chin is maintained subsequent to treatment, as are the changes in incisor inclination, although in diminished form. There are corresponding improvements in the soft tissue profile.