Correction of a Class III Malocclusion with All-on-4 Concept Implant Supported Full Mouth Rehabilitation: Clinical Case Report

Author(s):  
Mahmoud Serag ◽  
Heba Ismail ◽  
Joseph Zichella

This case report describes the correction of a skeletal Class III malocclusion by performing alveoloplasty and All-on-four styletitanium/acrylic (hybrid) fixed/detachable implant supported prosthesis.  A 76-year-old Hispanic,female patient with a noncontributory medical history presented to the clinic with a chief complaint of “I cannot wear my upper partial denture, it keeps on breaking”. Intraoral examination revealed significant inter-arch Class III relation, supra-erupted mandibular dentition, and significant loss of the vertical dimension of occlusion. Surgical treatment included edentulation of the patient in addition to a significant mandibular alveoloplasty in order to correct the patient’s malocclusion prosthetically. Through proper planning and execution, a skeletal Class III relationship was corrected with an implant supported All-on-four maxillary/mandibular prostheses. An edge-to-edge incisal relationship was achieved along with an appropriate vertical dimension of occlusion. The preplanning protocol allowed determination of the required alveoloplasty in order to obtain sufficient restorative space to allow for the correction of the skeletal malocclusion prosthetically.

2012 ◽  
Vol 38 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Sompop Bencharit ◽  
Dale J. Misiek ◽  
Linda A. Simon ◽  
Arabella Malone-Trahey

2019 ◽  
Vol 24 (5) ◽  
pp. 52-59
Author(s):  
Mehrnaz Fakharian ◽  
Erfan Bardideh ◽  
Mostafa Abtahi

ABSTRACT Introduction: Skeletal Class III malocclusion is one of the most challenging malocclusions to treat. In around 40% of Class III patients, maxillary retrognathia is the main cause of the problem and in most patients, orthopedic/surgical treatments includes some type of maxillary protraction. Objective: The aim of this case report was to describe a treatment method for a patient with maxillary retrognathia and Class III skeletal discrepancy using mandibular and maxillary skeletal anchorage with intermaxillary elastics. Case report: A 13-year-old boy with maxillary retrognathia and mandibular prognathism was treated using bilateral miniplates. Two miniplates were inserted in the mandibular canine area and two other miniplates were placed in the infrazygomatic crests of the maxilla. Class III intermaxillary elastics were used between the miniplates. Results: After eight months of orthopedic therapy, ANB angle increased by 4.1 degrees and ideal overjet and overbite were achieved. Mandibular plane angle was increased by 2.1 degrees and the palatal plane was rotated counterclockwise by 4.8 degrees. Conclusion: This case showed that the skeletal anchorage treatment method may be a viable option for treating patients with Class III skeletal malocclusion.


Author(s):  
Vo Truong Nhu Ngoc ◽  
Nguyen Thi Thu Phuong ◽  
Nguyen Viet Anh

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.


2018 ◽  
Vol 1 (2) ◽  
pp. 93
Author(s):  
Fidiyah Inayati ◽  
I Gusti Aju Wahju Ardani

Background: Patients with congenital absence of a mandibular lateral incisor are often found having difficulty in achieving adequate functional occlusion. It may affect esthetics, mastication, speech, and occlusal balance. Purpose: This paper reported an agenesis treatment of one mandibular lateral incisor case using a space closure method. Case: A twenty-three years old female patient with agenesis of tooth 42, mandibular anterior crowding, multiple diastema on mandibular anterior teeth, and skeletal class III malocclusion. Case Management: Space closure method was chosen to correct the agenesis by considering the class III skeletal malocclusion and multiple diastema condition. Conclusion: Space closure method treatment improved the patient’s facial and dental esthetics, and it provided a good functional occlusion, despite the absence of a mandibular lateral incisor, which generally impairs the adequate incisal guidance.


2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.


2020 ◽  
Vol 54 (2) ◽  
pp. 150-156
Author(s):  
Sanjeev Verma

VG, 25-year-old male, presented with c/c of forwardly placed lower jaw and history of unsatisfactory previous orthodontic treatment. Extraorally, the patient had asymmetrical face and concave profile, competent lips, positive lip step, and chin deviated toward left side by 2 mm. Intraorally, the patient had Angle’s class III type 3 malocclusion with an overjet of (–1) mm, overbite of 0%, and cross-bite wrt 12, 21. The patient was skeletal class III due to macrognathic and prognathic mandible with hypodivergent growth pattern, and proclined upper and retroclined lower incisors. The patient was managed orthosurgically with bimaxillary surgery (maxillary advancement 3 mm + mandibular setback 7 mm) after presurgical decompensation. The case report discusses in detail the diagnosis and comprehensive management of the skeletal class III case.


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