Evaluating the effectiveness of clockwise rotation of the maxillomandibular complex for skeletal class III correction

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.

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Quick Correction of a Skeletal Class III Maloclussion in Primary Dentition with Face Mask Plus Rapid Maxillary Expansion Therapy

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.v0i0.32381 ◽

2018 ◽

Vol 20 (2) ◽

pp. 31-37

Author(s):

Hilda Alejandra Bedolla-Gaxiola DDS ◽

David Garrigós-Esparza DDS ◽

Juan Carlos Hernández-Cabanillas DDS, MS ◽

Miguel Ángel Rosales-Berber DDS ◽

Amaury Pozos-Guillén DDS, PhD ◽

...

Keyword(s):

Clinical Signs ◽

Face Mask ◽

Rapid Maxillary Expansion ◽

Primary Dentition ◽

Class Iii ◽

Class Iii Malocclusion ◽

Maxillary Expansion ◽

Orthopedic Treatment ◽

Clockwise Rotation ◽

Skeletal Class

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.

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A New Appliance for Class III Treatment in Growing Patients: Pushing Splints 3

Case Reports in Dentistry ◽

10.1155/2019/9597024 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Stefano Martina ◽

Roberto Martina ◽

Lorenzo Franchi ◽

Vincenzo D’Antò ◽

Rosa Valletta

Keyword(s):

Orthognathic Surgery ◽

Good Control ◽

Orthopedic Procedures ◽

Class Iii ◽

Maxillary Expansion ◽

Clockwise Rotation ◽

Skeletal Class ◽

Vertical Growth ◽

The Face ◽

Class Iii Treatment

Several orthopedic procedures have been used in early treatment to reduce the need for orthognathic surgery in skeletal Class III. The most used treatment is Rapid Maxillary Expansion and Facemask. This procedure also determines a clockwise rotation of the mandible, increasing the vertical dimensions of the lower third of the face. Therefore, the control of vertical dimension appears to be a key objective in Class III hyperdivergent patients. This article shows two skeletal Class III patients treated with a new appliance (Pushing Splints 3), that is able to correct sagittal discrepancy with a good control of the vertical growth. In both cases, Class I relationship with a proper Overjet and Overbite was achieved with improvement of profile. The final cephalometric values demonstrated a stable sagittal relationship and a good control of the vertical growth. The specific biomechanic features of the PS3 appliance permit the improvement of the sagittal jaw relationship, delivering at the same time vertical vectors that are able to control the alveolar and skeletal components of the vertical growth. This could be useful in the treatment of Class III hyperdivergent patients.

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Frontal Changes in the Lower Face After Clockwise Rotation of the Maxillomandibular Complex Without Perisurgical Orthodontic Treatment in Angle Class I and Skeletal Class III Women

Aesthetic Plastic Surgery ◽

10.1007/s00266-017-0838-7 ◽

2017 ◽

Vol 41 (3) ◽

pp. 641-649 ◽

Cited By ~ 3

Author(s):

Sang Woo Lee ◽

Jeongmok Cho ◽

Kikap Kim ◽

Seung Hyun Ahn

Keyword(s):

Orthodontic Treatment ◽

Class I ◽

Class Iii ◽

Clockwise Rotation ◽

Lower Face ◽

Skeletal Class ◽

Angle Class

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Maxillary Protraction Appliance Effect on the Size of the Upper Airway Passage

The Angle Orthodontist ◽

10.2319/122806-535.1 ◽

2008 ◽

Vol 78 (2) ◽

pp. 209-214 ◽

Cited By ~ 46

Author(s):

Hüsamettin Oktay ◽

Esengül Ulukaya

Keyword(s):

Upper Airway ◽

Class Iii ◽

Class Iii Malocclusion ◽

Clockwise Rotation ◽

Skeletal Class ◽

Maxillary Protraction ◽

Pharyngeal Airway ◽

Before And After ◽

Treatment Changes ◽

Lateral Head

Abstract Objective: To test the hypothesis that maxillary protraction appliances (MPA) have no effect on the size of the upper airway passage and craniofacial structures in adolescent patients. Materials and Methods: Twenty patients (5 male and 15 female; mean age 11.5 years) with skeletal Class III malocclusion were included in this study. The records of all patients who had maxillary protraction treatment and had lateral head radiographs taken before and after their protraction treatments were obtained from the files of treated cases. Treatment changes were determined by means of linear, angular, and area measurements. Data were analyzed statistically by means of paired t-test and correlation analysis. Results: Significant increases were observed in the width and area of the pharyngeal airway. Significant increases also occurred in the sagittal growth of the maxilla, while a clockwise rotation and inhibition of sagittal growth were observed in the mandible. Conclusions: The hypothesis was rejected. The size of the upper airway can be increased by means of MPA application.

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Correction of skeletal Class III malocclusion with clockwise rotation of the maxillomandibular complex

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2010.01.038 ◽

2012 ◽

Vol 141 (2) ◽

pp. 219-227 ◽

Cited By ~ 15

Author(s):

I-Ming Tsai ◽

Chen-Hui Lin ◽

Yu-Ching Wang

Keyword(s):

Class Iii ◽

Class Iii Malocclusion ◽

Clockwise Rotation ◽

Skeletal Class

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3D Finite Element Analysis of the Effects of Lefort I Corticotomy on the Temporomandibular Joint (TMJ) and Maxilla in Skeletal Class III Malocclusion Patients

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3502 ◽

2021 ◽

Vol 11 (1) ◽

pp. 96-103

Author(s):

Mohamed Mejbel ◽

Hala Sadek Alosman ◽

Lokman Onur Uyanik

Keyword(s):

Stress Distribution ◽

Temporomandibular Joint ◽

Type A ◽

Type B ◽

Class Iii ◽

Class Iii Malocclusion ◽

Clockwise Rotation ◽

Element Analysis ◽

Skeletal Class ◽

Maxillary Protraction

Objective: The purpose of this study was to evaluate the influence of Lefort I corticotomy using two skeletally anchored maxillary protraction protocols on temporomandibular joint (TMJ) and maxilla of skeletal class III malocclusion patients using three-dimensional finite element analysis. Methods: Protraction forces of 500 gm per side were applied on maxilla with two different types of Lefort I corticotomy, type A and type B osteotomy using two skeletally anchored maxillary protraction appliances: skeletally anchored facemask and bone-anchored with class III traction. Results: For the facemask appliance the osteotomy types presented clockwise rotation in contrast with bone-anchored with class III traction which showed counter-clockwise rotation. Within the sagittal plane, the most significant amount of anterior displacement was associated with bone-anchored with class III traction type A osteotomy. For the temporomandibular joint, the maximum stress distribution was concentrated in the anterior aspect condyle and superior aspect of the glenoid fossa for the two appliances. However, the stress distribution in bone-anchored with class III traction was more than skeletally anchored facemask. Conclusion: Using Lefort I corticotomy can be a useful alternative for maxillary protraction in adult patients. Bone anchored with class III traction was more effective for maxillary forward displacement than skeletally anchored facemask. However, the stress distribution on TMJ in bone-anchored was more than that in the facemask. However, the amount of rotation in type A cutting was more than in type B cutting.

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Dentoskeletal Effects of the Modified Tandem Appliance vs the Facemask Appliance in the Treatment of Skeletal Class III Malocclusion: A Single-center, Randomized Controlled Trial

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1883 ◽

2016 ◽

Vol 17 (7) ◽

pp. 522-529 ◽

Cited By ~ 1

Author(s):

Amro H Husson ◽

Ahmad S Burhan ◽

Fadwa B Salma ◽

Fehmieh R Nawaya

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

T Test ◽

Class Iii ◽

Single Center ◽

Class Iii Malocclusion ◽

Clockwise Rotation ◽

Skeletal Class ◽

Randomized Controlled ◽

Lower Incisors

ABSTRACT Aims The aim of this randomized controlled trial was to compare the skeletal and dentoalveolar effects of the modified tandem appliance (MTA) vs the facemask (FM) with rapid maxillary expansion. Materials and methods Thirty-two patients, aged 7 to 9 years were recruited. Eligibility criteria included skeletal class III malocclusion that resulted from the retrusion of the maxilla. Randomization was accomplished to divide the sample into two equal groups to be treated with either MTA or FM. Lateral cephalometric radiographs were obtained before treatment and after 2 mm positive overjet was achieved. Intragroup comparisons were performed using paired-sample t-test, and intergroup comparisons were performed using two-sample t-test at the p ≤ 0.05 level. Results Thirty-two patients (16 in each group) were available for statistical analysis. The pretreatment variables of both groups were similar. Both treatment therapies showed similar significant increase in the SNA and ANB angles, accompanied by slight decrease in the SNB angle. The increase in the SN:GoMe angle, Bjork's sum, and the overjet were significantly greater in the FM group. The forward movement of upper dentition was similar in both groups. Although the lower incisors retrusion was significantly greater in the FM group than in the MTA group, the uprighting of the lower molars was significantly greater in the MTA group. Conclusion Both appliances showed similar effects apart from less clockwise rotation of the mandible, less retrusion of the lower incisors, and greater uprighting of the lower molars in the MTA group. Clinical significance Both the MTA and the FM groups are effective in treating class III malocclusion. The MTA group is more efficient in controlling the clockwise rotation and gaining some space in the lower arch. How to cite this article Husson AH, Burhan AS, Salma FB, Nawaya FR. Dentoskeletal Effects of the Modified Tandem Appliance vs the Facemask Appliance in the Treatment of Skeletal Class III Malocclusion: A Single-center, Randomized Controlled Trial. J Contemp Dent Pract 2016;17(7):522-529.

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