Camouflage treatment of skeletal Class III malocclusion with multiloop edgewise arch wire and modified Class III elastics by maxillary mini-implant anchorage

Abstract

Objective: To evaluate the effect of the multiloop edgewise arch wire (MEAW) technique with maxillary mini-implants in the camouflage treatment of skeletal Class III malocclusion. Materials and Methods: Twenty patients were treated with the MEAW technique and modified Class III elastics from the maxillary mini-implants. Twenty-four patients were treated with MEAW and long Class III elastics from the upper second molars as control. Lateral cephalometric radiographs were obtained and analyzed before and after treatment, and 1 year after retention. Results: Satisfactory occlusion was established in both groups. Through principal component analysis, it could be concluded the anterior-posterior dental position, skeletal sagittal and vertical position, and upper molar vertical position changed within groups and between groups; vertical lower teeth position and Wits distance changed in the experimental group and between groups. In the experimental group, the lower incisors tipped lingually 2.7 mm and extruded 2.4 mm. The lingual inclination of the lower incisors increased 3.5u. The mandibular first molars tipped distally 9.1u and intruded 0.4 mm. Their cusps moved 3.4 mm distally. In the control group, the upper incisors proclined 3u, and the upper first molar extruded 2 mm. SN-MP increased 1.6u and S-Go/N-ME decreased 1. Conclusions: The MEAW technique combined with modified Class III elastics by maxillary miniimplants can effectively tip the mandibular molars distally without any extrusion and tip the lower incisors lingually with extrusion to camouflage skeletal Class III malocclusions. Clockwise rotation of the mandible and further proclination of upper incisors can be avoided. The MEAW technique and modified Class III elastics provided an appropriate treatment strategy especially for patients with high angle and open bite tendency. (Angle Orthod. 2013;83:630-640.)

Camouflage treatment of skeletal Class III malocclusion with asymmetry using a bone-borne rapid maxillary expander

“…9 To avoid this, several studies have reported mini-implant-assisted distalization of the lower dentition. [8][9][10][11][12] The advantage of this method is its ability to tip the lower molars distally with intrusion and the lower incisors lingually with extrusion, while avoiding any movement of the upper dentition. [8][9][10][11][12] Miniimplants can be installed in the posterior area of the maxilla or the mandible, with a goal to cancel or avoid the vertical force vector of the Class III elastics.…”

“…[2][3][4][5] Class III elastics result in mesial movement of the upper dentition and distal movement of the lower dentition with proclination of upper and retroclination of the lower dentition. 2,[5][6][7][8] They also induce extrusion of the upper molars and lower incisors, resulting in counterclockwise rotation of the occlusal plane and an increase in the facial height. 5,8 However, proclined upper incisors and flat smile arcs are unfavorable esthetic outcomes.…”

“…2,[5][6][7][8] They also induce extrusion of the upper molars and lower incisors, resulting in counterclockwise rotation of the occlusal plane and an increase in the facial height. 5,8 However, proclined upper incisors and flat smile arcs are unfavorable esthetic outcomes. The position and inclination of the upper incisors and the sagittal cant of the occlusal plane are important components of facial and smile esthetics.…”

“…9 To prevent these undesirable changes, several studies have reported mini-implantassisted distalization of the lower dentition. [8][9][10][11][12] In the camouflage treatment approach, the clinician will address the sagittal discrepancy and will consider nonsurgical maxillary expansion. Tooth-anchored expanders have been conventionally used, but they have several disadvantages, such as limited skeletal expansion, undesirable buccal tipping of the teeth, and buccal bone dehiscence.…”

Büyüme Ve Geli̇şi̇mi̇ Tamamlanmiş Olan Sinif Iii Bi̇r Hastanin İskeletsel Ankraj Kullanarak Kamuflaj Tedavi̇si̇ (Olgu Sunumu)

“…Bu durum fasiyal profilin statik ve dinamik güzelliğini fazlasıyla bozmakta ve aynı zamanda tedavinin stabilitesini de riske atmaktadır. 13,14 Sınıf III malokluzyonun kamuflaj tedavisinde son yıllarda oldukça popüler olan iskeletsel ankraj mekaniklerinin kullanımı ile mandibular dentistyonun en-masse distalizasyonu maksiller keserlerin aşırı proklinasyonunu engellemek açısından oldukça etkili olmaktadır. 12,14 Bu vaka raporunun amacı, iskeletsel Sınıf III malokluzyona sahip büyüme ve gelişimi tamamlanmış olan bir hastanın iskeletsel ankraj kullanılarak yapılan kamuflaj tedavisinin sonuçlarını sunmaktır.…”