Early Treatment Protocol for Skeletal Class III Malocclusion
What is the skeletal relationship in class1 malocclusion? (3). A. Class 2. B. Class 1. C. Class 2 with incisial retroclination. D. Class 2 with incisal. 3- DDS, MSc, PhD, Department of Stomatology, Bauru School of Dentistry, . relationship and increasing Class II malocclusion anteroposterior occlusal . the maxillary incisors may be severely labially . ;(4); quiz The relation of the upper and lower incisors when in tooth contact (centric the incisor relationship as Class I, Class II division I or division II, and Class III.
Accordingly, significant sagittal changes are induced, thus allowing a non-surgical correction of the malocclusion in several cases 6, The observation of clinical reports 5,13 has indicated the advantages of an early treatment, performed at early mixed dentition.
incisor relationship - oi
It is important to note that, in order to achieve a good outcome, the treatment should be started before the pubertal growth spurt, taking great advantage of its potential.
Furthermore, it should be taken into account that the end of the maxilla growth preceeds the growth of the mandible.
The aim of this study was to describe and discuss the treatment of a patient with Class III malocclusion, whose treatment protocol comprised two phases: Case Report Diagnosis and Etiology A nine-year-andmonth-old female patient sought orthodontic treatment with chief complaint of an anterior crossbite.
During the anamnesis, a good general health condition was observed without deleterious oral habits. Facial evaluation showed lack of middle third development Fig. In the intraoral examination, at IP Fig.
At CR, an edge-to-edge incisor relationship was observed, which improved the prognosis Fig. Radiographic examination was performed aiming to complement the clinical examination for establish the diagnosis. A panoramic radiograph showed the presence of all permanent teeth either already erupted or at the several stages of formation, in mixed dentition.
In cases where the mandible has an anterior deviation, it is essential to take a lateral cephalogram at CR, so that the low severity of the malocclusion may be ascertained and greatly favor treatment prospects.
These appliances treatment results depend on patient's compliance.
Initially, the Eschler's appliance was chosen in this case, followed by the facemask protocol considering the maxillary deficiency compounding the Class III malocclusion Case Description In this clinical case, the treatment protocol comprised two phases: The interceptive phase started immediately after the clinical and radiographic evaluation, with a removable orthopedic appliance: This appliance is composed of: Adams clasp for molars, and intermolar auxiliary clasps for deciduous teeth and premolars, b Eschler's labial bow, made in 0.
If necessary, springs can be added to correct the anterior crossbite, and an expander screw, to correct the posterior crossbite.
The patient used the appliance for 10 months, with poor compliance, especially regarding the expander screw activation. Notwithstanding, significant improvement of the anterior crossbite was observed at IP Fig. However, an adequate correction of the posterior crossbite and improvement of the facial profile were still necessary. Intraoral photographs showing pre-expansion aspect. Extraoral photograph showing the maxillary protraction face mask. Intraoral photograph previous to the reverse traction of the maxilla.
Extraoral aspect after the active phase of the maxillary protraction. Superimposition of the lateral cephalogram tracings at the beginning of the treatment black and after the reverse traction of the maxilla red. Intraoral photograph showing the comprehensive phase.
Accordingly, rapid maxillary expansion RME was performed, followed by maxillary protraction 2,4,5,9,10,13, Besides correcting the posterior crossbite, RME stimulates sutural cellular activity, enhancing protraction results 3,6, This can be performed by using a Hyrax-type expander, composed of buccal hooks soldered onto the appliance to receive the protraction elastics Fig.
On the 14th day of activation, a facemask for maxillary protraction was installed Fig. Maxillary protraction was carried out during the active phase of RME, and the face mask was used during 14 hours per day. A large array of extraoral appliances for maxillary protraction is available. In this case, Turley's face mask was chosen, which requires an impression of the patient's face with alginate.
Then a cast of the patient's face was obtained at a laboratory to build an individual appliance. September 9, A malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaws close. Edward Angle, who is considered the father of modern orthodontics, was the first to classify malocclusion.
Angle believed that the anteroposterior dental base relationship could be assessed reliably from first permanent molar relationship, as its position remained constant following eruption. According to Angle, the mesiobuccal cusp of the maxillary first molar aligns with the buccal groove of the mandibular first molar.
The maxillary canine occludes with the distal half of the mandibular canine and the mesial half of the mandibular first premolar.
- Class 1 Malocclusion
- Developing Class III malocclusions: challenges and solutions
The teeth all fit on a line of occlusion which, in the upper arch, is a smooth curve through the central fossae of the posterior teeth and cingulum of the canines and incisors, and in the lower arch, is a smooth curve through the buccal cusps of the posterior teeth and incisal edges of the anterior teeth. There is alignment of the teeth, normal overbite and overjet and coincident maxillary and mandibular midlines.
The mesiobuccal cusp of the maxillary first permanent molar occludes with the mesiobuccal groove of the mandibular first permanent molar. The distal incline of the maxillary canine occludes with the mesial incline of the mandibular first premolar. The molar relationship shows the mesiobuccal groove of the mandibular first molar is DISTALLY posteriorly positioned when in occlusion with the mesiobuccal cusp of the maxillary first molar.