Early Treatment Protocol for Skeletal Class III Malocclusion

Abstract

Skeletal Class III malocclusion, with its unpredictable and unfavorable nature, has been characterized by a growth pattern with doubtful prognosis regarding orthodontic mechanics, even when performed early. For a long time, Class III malocclusion was regarded as a synonym of mandibular prognathism, regardless of the affected skeletal structures. Mandibular growth, essentially determined by genetic factors, could barely be controlled by early orthodontic interventions. Therefore, the treatment choice was to wait for the patient to grow, and then make an orthodontic intervention associated with an orthognathic surgery. Maxillary involvement in the etiology of Class III malocclusion was conclusive to change orthodontic therapeutics. Maxillary intramembranous growth has a better response to orthopedic treatment, based on growth control and redirection, thus contributing for early intervention success. In several cases, excellent results have been achieved with rapid maxillary expansion and protraction. The aim of this study was to describe and discuss the treatment of a patient with Class III malocclusion, whose treatment planning comprised two phases: interceptive (mechanical orthopedic appliances) and comprehensive (fixed orthodontic appliance). The results of this case showed that Class III malocclusion should be intercepted as early as possible to permit growth redirection, mainly when the maxilla is the primary etiologic factor or dental and/or functional factors are involved. Diagnosis, treatment planning and prognosis depend on patient age, growth potential and severity of malocclusion. Early intervention, adequate indication of appliances, and patient compliance are key factors for good outcomes.

Skeletal Malocclusion: A Developmental Disorder With a Life-Long Morbidity

“…In our parallel study, “Discovery of genetic risk factors in micrognathia, a manifestation of Class II skeletal malocclusion”, we aim to identify genetic risk factors involved in the nonsyndromic micrognathia and determine the prevalence of micrognathia and retrognathia in Houston. The results of this study will enhance our understanding of the genetic role, thereby providing us with better understanding for the pathophysiology of the craniofacial disorders and molecular targets for therapeutic approaches [40]. …”

Dentoalveolar changes in post-twin block appliance orthodontic treatment class II dentoskeletal malocclusion

“…Treatment performed during the primary and mixed dentition periods produces better results compared to that started on conclusion of the mixed dentition period. 17,18 Early treatment produced superior results, evidenced by greater efficiency in moving the mandibulla forward and inhibiting maxillar growth, while simultaneously correcting the occlusal relation. 19 The samples analyzed were lateral cephalometric radiographs from class II dentoskeletal malocclusion with retrognathic mandible patients taken before and after orthodontic treatment using a twin block appliance.…”

Correction of Mandibular Prognathism in Combination with Polydiastema Using Rectangular Body Ostectomy: Literature Review and Case Report

“…Especially, lateral and posteroanterior cephalograms are very important for assessment of pre-post surgical procedure [21]. In presurgical period, three dimensional solid model was used for planning the surgical procedure.…”