A 7-year 10-month-old boy was evaluated for mouth breathing and snoring habits. Examination revealed soft convex tissues, maxillary protrusion, mandibular retrusion, and a class II sagittal osteofascial pattern. The patient failed a water holding test. He was clinically diagnosed with skeletal class II malocclusion caused by mouth breathing. Under interceptive guidance of occlusion (iGo), the malocclusion improved with fixed maxillary expansion using functional appliances and interventional treatment of mouth breathing by lip closure exercises. These treatments enabled the patient to gradually return to nasal breathing and guided him to develop physiological occlusion for a coordinated jaw-to-jaw relation. At the 5-year 2-month post-correction follow-up visit (at the age of 13 years), the patient had stable occlusion, a coordinated osteofascial pattern, and normal dentition, periodontium, and temporomandibular joints.
Background To evaluate the therapeutic effect of maxillary pad movable appliance combined with FR-III functional appliance in treating skeletal Class III malocclusion of deciduous teeth and provide a reference for optimizing clinical treatment methods. Methods A total of 30 pediatric patients were randomly selected between April 2012 and April 2019. They were in stage IIA osseous skeletal Class III malocclusion, treated with maxillary pad movable appliance to relieve the reverse, combined with FR-III functional appliance to maintain a median relationship to stage IIIA. A self-control study of children before and after treatment was used, and paired t-test was used to evaluate the changes in the measurement indexes of the IIA and IIIA stage X-rays and changes in the bone and soft tissue profiles. Results After 3 years of treatment, SNA, ANB, and NA-PA in the sagittal osteofacial index of the jawbones increased, SNB decreased, and the Y-axis angle in the vertical index of the jawbones increased. U1-SN, U1-NA, U1-NA distance, L1-MP, L1-NB, and L1-NB distance in the index of labial inclination of upper and lower central incisors increased, while U1-L1 decreased. The sagittal anomalies of the jawbones were improved, and there were significant differences before and after treatment (P < 0.05). FCA, ULP, and UL-EP increased, soft-tissue facial prominence and facial height increased, and the relationship between the upper lip and the aesthetic plane was harmonious. None of the 30 children with skeletal Class III malocclusion in the deciduous stage experienced recurrence in stage IIIA. Conclusions Combined treatment with the maxillary pad movable appliance and the FR-III functional appliance is suitable for children with skeletal Class III malocclusion in the deciduous stage.
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