Diagnosis and conservative treatment of skeletal Class III malocclusion with anterior crossbite and asymmetric maxillary crowding

Abstract

Highlights:1. Without extractions or orthognathic surgery, a differential diagnosis, utilizing three methods (DI, 3-Ring and Extraction Decision Tree) revealed that the patient's desire for conservative treatment was feasible.2. Despite 12mm of asymmetric crowding in the maxillary arch, the problem was treated to an optimal result without excessive arch expansion and incisal flaring by using PSL brackets.3. For the present patient, the anterior cross bite and deep bite were corrected simultaneously in ~5 months, utilizing anterior BTs and early light class III elastics as the principle active mechanics. Pink and White (P&W) dental esthetic score of 3. The worksheets for the DI, CRE, and P&W scores are attached within this case report.

Management of the Vertical Dimension in the Camouflage Treatment of an Adult Skeletal Class III Malocclusion

“…However, the patient refused the surgical inter-vention. Therefore, a compensatory orthodontic treatment was considered and the options were the use of class III intermaxillary elastics, treatment with miniplates [12] or extraalveolar mini implants [13,14], treatment with premolar extractions [10], and the adoption of the MEAW [7,8] technique. Since the patient had an FMA of 20.50°, a treatment with premolars extractions could reduce even more the occlusal support in the posterior region.…”

Tratamiento ortodóncico de camuflaje de una maloclusión de Clase III. Reporte de caso

“…Sin embargo, existen otras variables que se deberían tomar en cuenta para diferenciar si un caso es de camuflaje o para cirugía. Tseng et al determinaron en su estudio seis parámetros cefalométricos como medición de necesidad de tratamiento quirúrgico en un paciente de Clase III, donde el paciente es recomendado a tener una cirugía ortognática por tratamiento si solo cuatro de las seis condiciones se cumplen 1,23 . Los parámetros fueron overjet ≤ -4,73 mm, índice de Wits ≤ -11,18 mm, IMPA≤ 80,8°, relación Mx/Mn ≤ 65,9%, overbite ≤ -0,18 mm y ángulo gonial ≥ 120,8°.…”

A 14-years old boy having excessive overjet and traumatic bite

“…Mohammad Rafiqul Islam (MS Resident): Class III malocclusion is characterized by mandibular prognathism, anterior crossbite, negative overjet and underbite. 14,15 Furthermore, the mesiobuccal cusp of upper molars occludes not only in the mesiobuccal groove but distal to it. 16,17 It is more complicated when the lower anterior teeth are more prominent than that of the upper anterior teeth.…”