Early Management of Class III Malocclusion in Mixed Dentition

Abstract

A bstract Aim Skeletal class III malocclusion are the most challenging orthodontic problem to treat. Diagnosis and treatment in early stage was important to boost self-esteem of patient. Our aim was to correct skeletal relationship and anterior crossbite to enhance the growth of maxilla. Background Class III malocclusion can be due to retrognathic maxilla, prognathic mandible or combination. Complexity of class III malocclusion depends upon abnormal growth pattern of maxilla and mandible. Maxilla growth ceases around 8–10 years and mandible continue till 16 years. Early intervention boosts self-esteem of the patient. Case description This case presents with clinical feature of retrognathic maxilla at the age of six years. The patient had concave profile with incompetent lips. The mentolabial sulcus was normal and obtuse nasolabial angle with high clinical Frankfurt mandibular angle (FMA). There was reverse overjet of 1 mm. Cephalometric analysis showed a class III skeletal pattern with retrognathic maxilla and orthognathic mandible with increase in lower facial height and increases in gonial angle. The rapid maxillary expansion (RME) with reverse pull face mask was planned. The expansion screw was activated to loosen the circumaxillary suture. Conclusion After active treatment anterior crossbite was corrected. The patient sagittal discrepancy was improved. Early mixed dentition period is the best time to begin class III treatment. Clinical significance Early treatment with maxillary protraction and palatal expansion can correct most anterior–posterior skeletal discrepancy. How to cite this article Jha AK, Chandra S. Early Management of Class III Malocclusion in Mixed Dentition. Int J Clin Pediatr Dent 2021;14(2):331–334.

The Early Intervention of a Class III Malocclusion With an Anterior Crossbite Using Chincup Therapy: A Case Report

“…First, some higher anterior teeth that erupt lingually interact with lower teeth due to occlusal interference, which prevents correct mandibular closure in the centric relation. Second, the mandibular arch is wider posteriorly than the maxillary arch, which leads to the development of the posterior crossbite [ 4 ]. A posterior crossbite occurs when the mandible moves forward, causing its broader posterior arch to occlude with the straight frontal section of the maxilla [ 8 ].…”

“…In cases of late deciduous or early mixed dentition, the chincup is especially useful for treating MP [ 3 ]. After the intermaxillary skeletal imbalance is resolved, the appliance is changed to a retainer for the balance of the treatment period by reducing the force applied to the chincup and the amount of time it is used [ 4 ].…”

“…Treatment plans for adults are based on how severe the malocclusion is. Camouflage is a compensatory orthodontic treatment that modifies the position of the teeth relative to their supporting bone, to disguise underlying jaw discrepancies [ 4 ]. It can be used to manage mild Class III malocclusion with an acceptable facial profile.…”

Clear Aligners in the Growing Patient: A Systematic Review

“…Early orthodontic treatment remains a subject of debate, yet the potential to rectify malocclusions in their initial stages is undeniably appealing [46]. Conditions such as posterior crossbite, Class III dentoskeletal issues, impacted teeth, and excessive overjet can all benefit from interceptive treatment [47,48].…”

Genes and Pathways Associated with Skeletal Sagittal Malocclusions: A Systematic Review

“…Skeletal class II and III malocclusions are disorders with a sagittal discrepancy between the maxilla and the mandible [ 2 , 3 ]: patients diagnosed with skeletal class II malocclusion exhibit an anterior position of the maxilla in comparison with the mandible, which could result from mandibular retrognathism (reduced lower jaw growth and size) and/or maxillary prognathism (excessive upper jaw growth and size) [ 2 , 4 ]. In contrast, skeletal class III malocclusion, characterized by a posterior maxilla position related to the mandible, could be attributed to mandibular prognathism, maxillary retrognathism, or a combination of the two [ 3 , 5 ]. Both skeletal class II and III malocclusions significantly diminish patients’ ability to chew food effectively [ 6 ].…”