Early orthopedic treatment of skeletal Class III malocclusion: Correlating dentoskeletal changes with psychosocial outcomes using the modified SEC III protocol and PIDAQ.

Authors

Mohasin Moyikkal, Vincy Antony, Muhamed Km Shaloob, Prathapan Parayaruthottam, Gazanafer Roshan, Fahsina Hamza

Published in

Journal of the World federation of orthodontists. Sep 10, 2026. Epub Sep 10, 2026.

Abstract

Developing skeletal Class III malocclusion can cause facial aesthetic issues, low self-confidence, social discomfort, and psychological distress. This study aims to evaluate dentoskeletal and psychosocial changes following early orthopedic correction of developing skeletal Class III malocclusion using the modified SEC III protocol and to assess the correlation between cephalometric changes and patient-reported outcomes measured by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ).
About 15 patients aged 10 to 14 years with developing skeletal Class III malocclusion were included in this observational study and treated using the modified SEC III protocol incorporating rapid maxillary expansion, Class III elastics, and chin-cup therapy. Lateral cephalograms and Malayalam-translated PIDAQ obtained at pre-treatment (T1) and post-treatment (T2) were used to evaluate skeletal and dentoalveolar changes. Statistical analysis was performed using SPSS software. Normality was assessed with the Shapiro-Wilk test, while T1-T2 comparisons were analyzed using the Wilcoxon signed-rank test (P < 0.05). Spearman correlation analysis evaluated the association between cephalometric and psychosocial changes.
Significant improvement was observed in sagittal skeletal relationships following treatment. Sella nasion point A increased from 78.33° ± 0.49° to 82.07° ± 0.8°, sella nasion point B decreased from 81.07° ± 0.8° to 78.13° ± 0.74°, ANB improved from -2.67° ± 0.49° to 2.33° ± 0.49°, and Wits appraisal improved from -1.67 ± 0.49 mm to 0.73 ± 0.46 mm (P < 0.001). Significant improvement was also noted across all PIDAQ domains, with a strong correlation between skeletal correction and reduced psychosocial distress.
Early orthopedic intervention using the modified SEC III protocol was associated with meaningful skeletal correction and significant improvement in psychosocial well-being.

PMID:
42722578
Bibliographic data and abstract were imported from PubMed on 11 Sep 2026.

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