[Full text] Developing Class III malocclusions: challenges and solutions | CCIDE
The cephalometric analysis revealed a skeletal class III relationship (ANB 2°, WITTS . of class III malocclusion with maxillary expansion and face mask therapy. Class III malocclusion is a less frequently observed clinical problem than Class II or Peter Ngan, Hong He, in Current Therapy in Orthodontics, by an anterior crossbite and a skeletal Class I relationship, is excluded from this category. Class III malocclusion is characterized by anterior posterior dental disharmony, In adult patients, therapy may be performed by means of dental compensation, in the relationship of skeletal asymmetry between the mandible and maxilla.
After this, Edgewise standard metal brackets, slot 0. In the mandibular arch, in addition to the fixed appliance, the J-hook extraoral appliance with high pull was used. After the active period, the screw was stabilized and the appliance kept in place for three months. After removal of the Hyrax appliance, extraction of teeth 15 and 25 was required and alignment and leveling was performed with a sequence of 0.
In the mandibular arch, extraction of teeth 34 and 44 was initially required and alignment and leveling was started with a sequence of 0. This appliance was anchored directly on the arch, touching the canines, working as jigs with the purpose of distalizing the mandibular canines and simultaneously to favor rotation of the mandibular occlusal plane in the counterclockwise direction, which would be favorable to closing the open bite.
Due to the asymmetry and the need for greater distalization of tooth 33, after distalization of tooth 33, the J-hook was anchored to a hook welded to the arch between teeth 32 and 33, while the right side continued to play the role of a jig distalizing tooth Concomitantly, in the maxillary arch, closure of the spaces was performed in a reciprocal manner, with the objective of obtaining posterior anchorage loss together with retraction and uprighting of the incisors, and consequent open bite closure.
Retention in the maxillary and mandibular arches was performed with wraparound type removable retainers. Patient, a year-old boy was treated with an orthopedic face mask in conjunction with rapid maxillary expansion and standard pre-adjusted edgewise appliance. Treatment was completed after 3 years and proved to be stable following the active treatment. Class III malocclusion, face mask, rapid maxillary expansion Treatment of class III malocclusion in growing subjects is a challenging part of contemporary orthodontic practice.
Many treatment approaches can be found in the literature regarding orthopedic and orthodontic treatment in class III malocclusion, including intraoral and extraoral appliances such as a facial mask FM ,[ 1 ] functional regulator-3 appliance of Frankel[ 2 ] removable mandibular retractor,[ 3 ] chincup,[ 4 ] splints, class III elastics and chincup[ 5 ] and mandibular cervical headgear.
In addition, maxillary expansion is frequently needed in the treatment of class III malocclusions to increase the transverse width of the maxilla. According to McNamara[ 10 ] and Turley,[ 11 ] rapid maxillary expansion RME may enhance the protraction effect of the face mask by disrupting the maxillary suture system and it is widely accepted among the orthodontic community that the mid-face deficient class III patients should be treated before years of age.
Optimal timing for the orthopedic approach to class III malocclusion is related to early treatment, at either a prepubertal or a pubertal phase of development. Am J Hum Genet.
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Protraction of maxilla in rhesus monkeys by controlled extraoral forces. Biomechanical and clinical considerations of modified protraction headgear.
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