Distalization of the mandibular dentition with a ramal plate for skeletal Class III malocclusion correction

Abstract

The retromolar fossa is an anatomically suitable skeletal anchorage site. The aim of this report was to introduce a novel appliance for the correction of skeletal Class III malocclusions with mandibular dentition distalization. The placement site and the procedure of the ramal plate are described. The resulting force vectors are parallel to the functional occlusal plane leading to efficient molar distalization. This approach is demonstrated with 2 adult patients who refused a surgical treatment option. This ramal plate may be indicated for total arch distalization for nonextraction and nonsurgical cases.

Bone availability for mandibular molar distalization in adults with mandibular prognathism

“…This may have been related to the mandibular morphology of the patients with Class III malocclusions, in whom the ''V'' shape of the mandible is more divergent in the apex than in the furcation, with a lingually inclined mandibular body and a more laterally placed ramus. In previous reports [13][14][15][16] of clinical cases, the amount of molar distalization performed for the treatment of Class III malocclusion was as much as 6 mm. This amount is similar to the mean retromolar space assessed at the furcation level in the current study, but the patients had relatively high standard deviations for the observed retromolar spaces.…”

“…In addition, appropriate mechanics may need to be planned to control molar angulation during retraction. Mandibular molars tip distally to varying degrees when a distalizing force is applied because the force vector is above the center of resistance of the mandibular dentition, 14 which results in greater distalization of the crown than of the root. This type of movement may be favorable in cases in which bone availability decreases at the apical level.…”

Ortodontic Treatment Of Late Term Class III Malocclusion

“…36,37 Mini plaklar: Yerleştirilmeleri ve çıkarılmaları sırasında flep cerrahisi gerekmesi, daha invaziv bir işlem olduğundan, hastalar tarafından kabul edilmesi zor olmasına karşın, alt dental arkın distalizasyonu sırasında daha yüksek şiddette kuvvetler uygulanabilmesi açısından mini plaklar tercih edilebilmektedir. 38,39 Alt dental arkın en masse distalizasyonu sırasında mini plaklar genellikle retromolar bölgeye yerleştirilmekte, böylece diş hareketleri sırasında iskeletsel ankraj ünitesi ve diş köklerinin temasına bağlı olarak meydana gelebilecek komplikasyonların da önüne geçilebilmektedir. Ayrıca mini plakların kuvvet uygulanılan kısımları oklüzal düzleme daha yakın konumlanabilir, böylece distalizasyonkuvvetlerinin vektörleri daha horizontal yönde uygulanabilmektedir.…”

Morphological Characteristics of Soft Tissue Profile of Angle’s Class II Division I Malocclusion before and after Orthodontic Treatment

“…The previous research was mainly based on teeth, maxillofacial soft and hard tissue and different types of profile before and after treatment, but did not realize the importance of posterior occlusal plane. In this study, by measuring the change of posterior occlusal plane and soft tissue profile indexes before and after treatment, the writer tried to explore the correlation between posterior occlusal plane and soft tissue profile, so as to reveal the importance of them (Basciftci et al, 2004;Kook et al, 2016).…”