Extreme dentoalveolar compensation in the treatment of Class III malocclusion.
The orthodontic treatment of an adult patient with a skeletal Class III malocclusion, increased anterior facial height, negative overjet, and bilateral posterior crossbite is presented. Treatment options included mandibular first premolar or third molar extractions with dentoalveolar compensation or combined surgical-orthodontic treatment. Mandibular third molar extraction with dentoalveolar compensation was the treatment choice. Biofunctional brackets, with accentuated lingual crown torque on the maxillary incisors and accentuated buccal crown torque on the mandibular incisors, were used. The anterior crossbite was corrected with intermaxillary elastics from the palatal aspect of the maxillary incisors to the labial aspect of the mandibular incisors. Class III elastics moved the maxillary teeth mesially and assisted in retruding the mandibular teeth. Patient compliance with the elastics was excellent, and satisfactory dentofacial esthetics were achieved. This treatment protocol has rigorous indications, and it is not a routine plan. The mechanotherapy and the pros and cons of this approach are discussed.
Janson
Guilherme
G
Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, SP 17012-901, Brazil. jansong@travelnet.com.br
de Souza
José Eduardo Prado
JE
Alves
Flávio de Andrade
Fde A
Andrade
Pedro
P
Nakamura
Alexandre
A
de Freitas
Marcos Roberto
MR
Henriques
José Fernando Castanha
JF
D000222:Adaptation, Physiological; D000328:Adult; D003799:Dental Stress Analysis; D005260:Female; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D008964:Molar, Third / Q000601:surgery; D009967:Orthodontic Appliances; D019516:Orthodontic Space Closure / Q000379:methods; D009971:Orthodontics, Corrective / Q000295:instrumentation / Q000379:methods*; D014081:Tooth Extraction; D019415:Torque; D014716:Vertical Dimension