scholarly journals Nonsurgical treatment of a hyperdivergent skeletal Class III patient with mini-screw–assisted mandibular dentition distalization and flattening of the occlusal plane

2021 ◽  
Author(s):  
Yiruo He ◽  
Yangyang Wang ◽  
Xinghai Wang ◽  
Jiangyue Wang ◽  
Ding Bai ◽  
...  

ABSTRACT Treatment of hyperdivergent skeletal Class III malocclusion is challenging for orthodontists, and orthognathic-orthodontic treatment is usually required. This report presents the successful nonsurgical treatment of a 20-year-old man who had a skeletal Class III malocclusion with anterior open bite, anterior and posterior crossbite, hyperdivergent growth pattern, steep occlusal plane, early loss of three first molars, and an uncommon convex profile with a retruded chin. An orthodontic camouflage treatment plan was chosen based on the etiology and the patient's complaints. Tooth #37 was extracted. Miniscrews were used for uprighting and intruding of the lower molars, distalization of the lower dentition, and flattening of the occlusal plane. After 34 months of active treatment, Class I relationships, proper anterior overjet and overbite, flat occlusal plane, and an esthetic facial profile were achieved. The results demonstrated that the biomechanics involved in the nonsurgical treatment assisted with miniscrews to distalize the mandibular dentition and flatten the occlusal plane while keeping the mandibular plane stable was effective for treating this hyperdivergent skeletal Class III patient with a convex profile and anterior open bite.

2011 ◽  
Vol 05 (01) ◽  
pp. 121-129 ◽  
Author(s):  
Demet Kaya ◽  
Tulin Ugur Taner

ABSTRACTThe aim of this case report was to present the orthodontic treatment of an adult with spaced dentition, Class III malocclusion, and open-bite tendency. A 28.4-year-old adult woman was concerned about the unesthetic appearance of her spaced dentition localized at both upper and lower arches while smiling. She had a mild tongue thrust, hypertropic upper frenum, and mild speech difficulty while pronouncing “s”. Her profile was straight with prominent lips. Molar relationship was Class III on both sides. Anterior teeth were in an end-to-end relationship. Lower dental midline was deviated to the left side. Cephalometric analysis revealed a skeletal Class III relationship with hyperdivergent facial pattern. The treatment plan included myotherapeutic exercises for the tongue thrust habit and a diagnostic set-up for closure of diastemas. A strict retention protocol was followed combined with gingivoplasty, fiberotomy, and frenectomy procedures. All spaces were closed successfully, adequate overbite and overjet relationships were obtained, and tongue thrust habit and speech difficulty while pronouncing “s” were eliminated. Clinical and cephalometric results indicated the maintenance of the treatment outcome at 6-months post-retention period. (Eur J Dent 2011;5:121-129)


2018 ◽  
Vol 7 (2) ◽  
pp. 56-59
Author(s):  
Dharma Laxmi Basukala

Skeletal Class III with openbite is one of the most difficult malocclusion to treat orthodontically. Generally, the morphological characteristics of this malocclusion are poor antero-posterior growth of the maxilla or excessive growth of the mandible with high angle. An 18-year-old male had Class III malocclusion with retrognathic maxilla and normal mandible with high angle. All third molars except on fourth quadrant were extracted to eliminate the posterior crowding. Multiloop Edgewise Arch-wire (MEAW) technique was used to upright the mesially inclined buccal teeth and to correct occlusal plane. In nine month time,  anterior cross bite and open bite were corrected; normal overjet, overbite and Class I canine relation were achieved.


2020 ◽  
Vol 157 (3) ◽  
pp. 408-421
Author(s):  
Oscar Mario Antelo ◽  
Thiago Martins Meira ◽  
Dauro Douglas Oliveira ◽  
Matheus Melo Pithon ◽  
Orlando Motohiro Tanaka

2018 ◽  
Vol 75 (11) ◽  
pp. 1138-1142
Author(s):  
Tatjana Cutovic ◽  
Julija Radojicic ◽  
Srboljub Stosic ◽  
Irena Mladenovic ◽  
Ruzica Kozomara

Introduction. Skeletal malocclusions, especially those with a prominent vertical component, always present a challenge for the interdisciplinary approach to their treatment planning. The aim of this report is to present a patient with a complex skeletal deformity in all three directions (vertical, sagittal and transverse). Case report. A twenty-four year old female patient with a skeletal Class III malocclusion, open bite and laterognathia, was firstly treated by orthodontic fixed appliances, whereas the dental decompensation of dentoalveolar structures was carried out and adjusted to their bone structures, thus enabling an adequate and sufficient reposition of the jaw. A surgical correction included bi-maxillary osteotomy due to pronounced vertical cephalometric parameters, necessitating a posterior maxillary intrusion and mandibular repositioning. In that manner, the relapse was prevented and a long-term stable result obtained. In the retention period, the patient wore removable bi-maxillary retention devices. Conclusion. The combined orthodontic-surgical treatment provided the Class I occlusion with aesthetic and functionally satisfactory results which were envisioned by the treatment plan.


2020 ◽  
Vol 47 (3) ◽  
pp. 257-264
Author(s):  
Chung How Kau ◽  
Zhendong Wang ◽  
Jue Wang ◽  
Deepak G Krishnan

Introduction: This case report describes the treatment of a 21-year-old man who presented in an orthodontic office for treatment but lived in a city 100 miles away and wanted the orthognathic surgery in another state in America. The patient presented with an anterior open bite and skeletal Class III relationship. Methods: The treatment plan included: (1) effective and careful communication of the treatment plan with the patient, orthodontist and oral and maxillofacial surgeon; (2) pre-surgical alignment and levelling of the teeth in both arches with Invisalign; (3) a long-distance communication between the orthodontist and the surgeon for surgical plan with virtual surgical planning (VSP Orthognathics; 3D Systems, www.3Dsystem.com ) online; (4) maxillary advancement (LeFort I osteotomy) with mandibular set-back (bilateral sagittal split osteotomy); (5) postsurgical correction of the malocclusion with clear brackets and aligners; and (6) retention and final small tooth movement adjustments with aligners/clear retainers. Results: The anterior open bite was treated, crowding was eliminated in the upper and lower anterior segment, correction of skeletal and dental Class III malocclusion was obtained, mandibular plane angle was reduced and facial profile improved. Conclusions: The results suggest that aesthetic and functional results can be achieved with long-distance communication of two specialties and with the combined use of clear aligners and clear fixed appliances.


2020 ◽  
Vol 10 ◽  
pp. 253-258
Author(s):  
Adith Venugopal ◽  
M. Srirengalakshmi ◽  
Anand Marya ◽  
Paolo Manzano

A variety of treatment options may be implemented on a Class III malocclusion associated with skeletal discrepancy ranging from functional orthopedics at an early age to orthognathic surgery in adults. In the current scenario, many Class III malocclusion patients are referred for orthognathic surgery without even considering the options of an orthodontic camouflage, as orthodontists do not want to burden themselves with the tedious treatment planning and risks involved with treating such cases. This case report describes a 27-year-old female diagnosed with a skeletal Class III malocclusion, severe open bite, and periodontally compromised dentition. Although orthognathic surgery was proposed as the best treatment modality, it was denied by the patient due to financial and psychological constraints. She was treated with mild upper arch expansion using archwires and upper premolar intrusion using temporary anchorage devices (TADs) alongside retraction of lower anterior teeth using TADs and intermaxillary elastics. At the end of 18 months of active treatment, a decent result was achieved with good occlusion and facial esthetics. Post-treatment results showed an improved profile and Class I canine relationships, with optimal overjet and overbite. The anterior open bite was corrected, and the overall facial balance was greatly improved. Extraoral photographs displayed a relaxed lip closure and an esthetic smile meeting the patient’s expectations. Two-year follow-up records demonstrated a stable occlusion and optimal facial esthetics.


2021 ◽  
Vol 32 (3) ◽  
pp. 120
Author(s):  
William Suryajaya ◽  
Haru Setyo Anggani

Pendahuluan: Perawatan ortodonti kamuflase adalah perawatan untuk menyamarkan diskrepansi skeletal dengan mengubah posisi dan angulasi gigi-gigi pada lengkung rahang. Perawatan tersebut merupakan perawatan yang dapat dipilih selain bedah ortognatik bagi kasus maloklusi skeletal kelas III pada pasien dewasa. Maloklusi skeletal kelas III sering pula disertai dengan keadaan lain seperti gigitan terbuka anterior yang menambah kompleksitas modalitas perawatan. Tujuan laporan kasus ini untuk menjelaskan pilihan modalitas perawatan pasien maloklusi skeletal kelas III secara kamuflase ortodonti. Laporan kasus: Pasien wanita usia 19 tahun 2 bulan datang ke klinik Ortodonti RSGM FKG UI dengan keluhan gigi atas depan tidak teratur dan gigi depan atas dan bawah tidak bertemu. Diagnosis menunjukkan pola skeletal kelas III dengan posisi maksila dan mandibula terhadap basis cranii retrognati (SNA 73°, SNB 74°, ANB -1°)  disertai dengan crowding sedang dan gigitan terbuka anterior. Tipe wajah pasien dolikofasial, simetris dan seimbang. Profil jaringan lunak dan skeletal cekung. Kasus ini dirawat dengan pendekatan ortodonti kamuflase tanpa pencabutan menggunakan piranti cekat standar Edgewise untuk mengoreksi crowding pada lengkung gigi atas dan bawah serta gigitan terbuka pada regio anterior. Perawatan ortodonti selesai dalam waktu 13 bulan dan crowding pada lengkung gigi atas dan bawah serta gigitan terbuka pada regio anterior telah terkoreksi. Simpulan: Perawatan ortodonti kamuflase pada maloklusi kelas III skeletal dengan gigitan terbuka anterior ringan merupakan pilihan perawatan yang cukup baik karena dapat mengoreksi maloklusi dengan kompensasi dentoalveolar sehingga diperoleh oklusi yang baik dan stabil. Hasil perawatan menunjukan hasil yang cukup baik dan dapat diterima oleh pasien.Kata kunci: Maloklusi skeletal kelas III, crowding, open-bite anterior, standar edgewise, ortodonti kamuflase. ABSTRACTIntroduction: Orthodontic camouflage is a treatment to disguise skeletal discrepancies by changing the teeth position and angulation in the jaw arch. This treatment is an option other than orthognathic surgery for skeletal class III malocclusion in adult patients. Skeletal class III malocclusion is often accompanied by other conditions such as an anterior open-bite which adds the complexity of the treatment modality. This case report was aimed to describe the choice of treatment modality for skeletal class III malocclusion patients by orthodontic camouflage. Case report: A female patient aged 19 years and two months came to the Orthodontic Clinics at the Faculty of Dentistry of University of Indonesia Dental Hospital (RSGM FKG UI) with complaints of irregular maxillary anterior teeth, and the maxillary and mandibular anterior teeth did not overlap. The diagnosis showed a skeletal class III pattern with the maxillary and mandibular position against the retrognathic cranii base (SNA 73°, SNB 74°, ANB -1°) accompanied by moderate crowding and anterior open-bite. The patient’s face type is dolichofacial, symmetrical and balanced, with the concave soft and skeletal tissue profiles. This case was treated with a non-extraction camouflage orthodontic approach using the standard edgewise fixed appliance to correct crowding in the maxillary and mandibular dental arches and open-bite in the anterior region. The orthodontic treatment was completed within 13 months, and crowding in the maxillary and mandibular dental arches and open-bite in the anterior region were corrected. Conclusion: Camouflage orthodontic treatment is a good treatment option for skeletal class III malocclusion with a mild anterior open-bite because it can correct malocclusion with dentoalveolar compensation to obtain a good and stable occlusion. The treatment results show good results and can be accepted well by the patient.Keywords: Skeletal class III malocclusion, crowding, anterior open-bite, standard edgewise, orthodontic camouflage.


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.


2021 ◽  
Vol 11 (6) ◽  
pp. 2520
Author(s):  
Andrea Deregibus ◽  
Simone Parrini ◽  
Maria Chiara Domini ◽  
Jacopo Colombini ◽  
Tommaso Castroflorio

Many studies report that maxillofacial growth is influenced by genetic and environmental elements and that incorrect breathing, chewing, sucking, and swallowing are promoting factors of malocclusion. This study aims to evaluate the function and the influence of the tongue positions in patients with Angle class III malocclusion, maxillary hypoplasia, and posterior crossbite. One hundred patients, aged between 6 and 12 years old, were enrolled for the study. In the first group, patients with a diagnosis of class III malocclusion, affected by maxillary hypoplasia, skeletal class III, and posterior dental crossbite were recruited. In the control group, not treated patients with no malocclusion, skeletal class I, and without posterior dental crossbite were selected. Regarding atypical deglutition, no statistical differences were reported between the two groups, and 14% of patients reported ankyloglossia. Statistical differences were found in tongue rest position and during the execution of “hold and pull” and “chuck” exercises. Results obtained in this observational study showed that the clinician (orthodontist or general dentist) should analyze the presence/absence of atypical swallowing, the anatomical and functional aspects, and the tongue behavior in the rest position.


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