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Background: Treatment of skeletal Class III malocclusion in growing patient with an anterior crossbite and open bite is challenging due to unpredictable results and potentially unfavorable growth. Growth modification in adult patients is not an alternative approach. Objective: Case report of a patient with Class III malocclusion in adult and anterior crossbite and open bite was treated with combine fixed appliances and orthognatic surgery. Treatment procedure: Treatment of anterior cross bite and open bite was completed in two phases. The first phase was to correct the dental alignment align and arch coordination with fixed orthodontic appliance. The second phase was to correct the skeletal discrepancy with orthognatic surgery. Conclusions: Orthognatic surgery is a good approach in treating anterior cross bite and open bite relating to skeletal problems in adult period. Changes in profile and occlusion were very obvious.

Background: Combination of poor dental hygiene and poor dental treatment lead to multiple missing teeth. Perio-dontics, orthodontics, oral & maxillofacial surgery, and prosthodontics treatments were undertaken in proper timing and sequence with an interdisciplinary approach. Objective: Proper diagnosis, treatment planning and teamwork were crucial to solve difficult cases. Case: A 30-year-old unilateral cleft lip and palate female patient with Class III malocclusion and several missing maxillary anterior and posterior teeth and mandibular posterior teeth came to the clinic to improve both her esthetic and function. Patient had a unilateral cleft lip and palate. Management: After initial periodontal care was completed, orthodontic treatment was completed to prepare her orthognathic surgery. Space consolidation and occlusion correction were also completed to prepare her for final prosthesis post surgery. Partial dentures were delivered by the prosthodontists. As a result, a stable Class I occlusion with good esthetic and func-tion treatment results were achieved. Conclusion: The case showed that proper diagnosis and treatment planning is very important especially in an interdisciplinary treatment of Class III malocclusion patient.

Background: The prevalence of Class III malocclusion is highest in Southeast Asia. In countries such as Malaysia and Indonesia, the prevalence is as high as 15.80%. Treatment timing and options are very important in treating Class III malocclusion. A protraction facemask or also known as reverse headgear is one of the most used appliances as an interceptive tool for Class III malocclusion in young patients. Objectives: This study aims to evaluate the profile changes in treating Indonesian young patients using a protraction facemask. Methods: The sample consisted of 63 subjects, 25 males and 38 females. Lateral cephalograms were traced and analyzed using CephaloMetrics AtoZ™ ver. 12 (Yasunaga Computer Systems, Co. Inc., Hanando-Minami, Fukui, Japan). A total of 16 traditional cephalometric measurements (13 skeletal measurements and 3 dental measurements) were used to describe changes between pretreatment and posttreatment cephalograms. All recorded data were analyzed using IBM SPSS version 21 (IBM Corporation, Armonk, New York, USA). Results: SNA (p˂0.030), ANB (p=0.000), and Wits appraisal values (p=0.000) showed significant differences out of all measurements. FMA and occlusal plane also showed changes and indicated that a facemask is helpful with treatment. Conclusion: Timing, duration, and patient compliance are very important in the management of Class III skeletal malocclusion using a protraction facemask. The use of facemask therapy among Indonesian pediatric patients resulted in an anterior and downward movement of the maxilla, backward rotation of the mandible, and a better orthopedic response.

Introduction: Impacted second molars, even though it is a rare occasion, may create additional problems for orthodontic treatment. Impacted second molars to orthodontic treatment are frequent problems, the family and the orthodontist should be aware of it. Both parents and the orthodontist should be aware of this problem early to prevent further complication. Good teamwork between the orthodontist and oral maxillofacial surgeon especially a good surgeon is needed in handling these type of cases, especially if it is involved in removing the impacted second molar. Without damaging the bone structure. The right time for treatment of impacted second molar is between the age of 11 to 14 years old. Impacted second molar lead to the lack of arch length of the patient. Objective: The case report was to describe the management of a female patient who has mandibular left and right impacted second molar treated. The chief complaint of the patient were protrusive mouth and having two impacted second molar as were told by her general dentist. Case report: A 15-years-old female patient with Class I molar relationship, bilateral second molar impaction and bimaxillary protrusion visited the clinic for orthodontic treatment. Extraction of four first premolar and mandibular second molar were completed. Both mandibular third molar were moved anteriorly to help close the space. Conclusion: Good cooperation from various disciplines and treatment planning to resolve the case can produce excellent and ideal results.