Skeletal Class III Malocclusion with Lateral Open Bite and Facial Asymmetry Treated with Asymmetric Lower Molar Extraction and Lingual Appliance: A Case Report

Abstract

A skeletal Class III malocclusion with open bite tendency is considered very difficult to treat orthodontically without surgery. This case report describes the lingual orthodontic treatment of an adult skeletal Class III patient with mandibular deviation to the left side, lateral open bite, unilateral posterior crossbite, zero overbite and negative overjet. The lower incisors were already retroclined to compensate with the skeletal discrepancy. The patient was treated by asymmetric molar extraction in the mandibular arch to retract the lower incisors and correct the dental midline, with the help of intermaxillary elastics. Lingual appliance was used with over-torqued lower anterior teeth’s brackets to control the torque of mandibular incisors. After a 30-month treatment, satisfactory smile and facial esthetics and good occlusion was achieved. A 12-month follow-up confirmed that the outcome was stable. Asymmetric molar extraction could be a viable option to retract mandibular incisors in Class III malocclusion with lower dental midline deviation.

Digital workflows for 3D-printed customised double-slotted lingual appliances: a case report

“…15 The double-slotted design of lingual appliances was chosen because engaging two arch wires in two directions allows for better simultaneous control over first and second-order movements. 16,17 Alternatively, single-slot lingual brackets may also be selected from the software library. However, the reduced bracket widths and inter-bracket spans of lingual appliances would reduce the rotation and angulation control when only one arch wire is engaged unless a timeconsuming double overtie technique is applied.…”

3D-printed indirect bonding trays and transfer jigs for lingual brackets: Digital workflows and two case reports

“…Unlike labial orthodontics, direct bonding is challenging in lingual orthodontics due to the variability and complexity of lingual tooth surface anatomy, along with difficulties in intraoral visualization and measurement of bracket positions. Therefore, indirect bonding offers significant advantages in lingual orthodontics, providing greater precision and control over the process [ 1 , 2 ]. In the analog laboratory technique, transfer jigs are fabricated after positioning lingual brackets on setup models with ideal tooth alignment [ 3 , 4 ].…”