Abstract

Existing literature supports the efficacy of PAOO in augmenting alveolar bone volume and facilitating orthodontic tooth movement. However, there is a paucity of literature addressing its application in the treatment of adults with skeletal Class III malocclusion. This retrospective clinical study aimed to compare the clinical efficacy of camouflage orthodontic treatment combined with and without PAOO in adult patients presenting with skeletal Class III malocclusion. A retrospective study was performed in 38 patients with mild to moderate skeletal Class III malocclusion who underwent orthodontic treatment. Patients were divided into two cohorts: the experimental group, which underwent the PAOO procedure combined with orthodontic treatment, and the control group, which received traditional camouflage orthodontic treatment alone. Radiographic assessments, including lateral cephalograms and cone-beam computed tomography (CBCT) scans, were conducted before treatment (T0) and after treatment (T1) to evaluate changes in maxillary incisor inclination, alveolar bone thickness, and various skeletal and soft tissue parameters. The experimental group exhibited a significant reduction in the axial inclination of the maxillary incisors after treatment (P < 0.05; U1-PP, -4.97 ± 5.23°). The root apex of the maxillary incisors moved labially, and the A-point moved forward. In contrast, the control group demonstrated significant proclination of the maxillary incisors (P < 0.05; U1-PP, 6.80 ± 7.89°). The ANB assessments demonstrated significant improvements (P < 0.05; 3.03 ± 1.62°), with a significant difference between groups that favored the experimental group. Nasolabial angle and G Vert-Sn increased significantly only in the experimental group (P < 0.05; Nasolabial A, 9.47 ± 12.67°; G Vert-Sn, 2.19 ± 2.56 mm). Compared with T0, labial bone thickness significantly increased in the experimental group at T1, while it decreased significantly in the control group. The integration of PAOO with orthodontic treatment appears to enhance labial alveolar bone augmentation and facilitate the labial movement of maxillary incisor roots in patients with skeletal Class III malocclusion. Concurrently, it results in significant improvements in patients' aesthetics of both soft and hard tissue profiles.