Interception of developing class III malocclusion with temporary anchorage devices: A case report

Introduction:
Class III malocclusion is a result of maxillary deficiency, mandibular prognathism or a combination of both, often accompanied by an anterior crossbite and a concave profile.

Aim:
The aim of this work was to report and analyze a case of class III malocclusion.

Case study:
The patient, a 12-year-old boy, attended Maxillo-Facial Clinic with the complaint of his lower jaw being in front. The pre-treatment examination showed a slight flattened subnasal area and the reverse overjet. For the maxillary protraction, de Clerck method of bone anchors and class III elastics were applied. After previous palatal expansion, the boneanchored maxillary protraction was applied. The surgery was performed under general anesthesia. The surgical procedure consisted in placing four miniplates – one in each infrazygomatic buttress of the maxilla, and one in the anterior mandible between, and inferior to the left and right permanent lateral incisor and canine. The miniplates were loaded 3 weeks after the surgical procedure. After 7 months of treatment, the anterior crossbite was corrected.

Results and discussion:
Cephalometric evaluation between the beginning of treatment and the end of maxillary protraction showed marked increase in ANB and Wits. A counterclockwise rotation of the mandible was observed, as well as a slight clockwise rotation of the maxillary bone. The obtained results correspond to de Clerck's cephalometric investigations in class III patients who were treated with the use of bone-anchored maxillary protraction.

Conclusions:
Temporary anchorage devices application enabled correction of the anterior crossbite and enhanced midfacial growth in young maxillary-deficient patient.

CONFLICT OF INTEREST

None declared.

REFERENCES (10)

De Clerck HJ, Cornelis MA, Cevidanes LH, Heymann GC, Tulloch CJ. Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency. J Oral Maxillofac Surg. 2009;67(10):2123–2129.

Google Scholar

Maciejak M, Maciejak D, Stopa Z, Wanyura H. Morphological assessment of facial skeleton in patients with skeletal Class III malocclusions. J Stomatol. 2011;64(11):851–864.

Google Scholar

Parayaruthottam P, Antony V, Francis PG, Muhamed Shaloob KM, Hassan KJ. Interception of a developing Class III malocclusion with facemask therapy. J Orthod Res. 2014;2:38–41.

Google Scholar

Nguyen T, Cevidanes L, Cornelis MA, Heymann G, de Paula LK, De Clerck H. Three-dimensional assessment of maxillary changes associated with bone anchored maxillary protraction. Am J Orthod Dentofacial Orthop. 2011;140(6):790–798.

Google Scholar

Cevidanes L, Baccetti T, Franchi L, McNamara Jr JA, De Clerck H. Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion. Angle Orthod. 2010;80(5):799–806.

Google Scholar

De Clerck H. Interview. Dent Press J Orthod. 2012;17(3):7–13.

Google Scholar

Antoszewska J, Kosior M, Antoszewska N. Treatment approaches in Class III malocclusion with emphasis on maximum skeletal anchorage – review of literature. J Stomatol. 2011;64(9):667–683.

Google Scholar

Baccetti T, De Clerck HJ, Cevidanes LH, Franchi L. Morphometric analysis of treatment effects of boneanchored maxillary protraction in growing Class III patients. Eur J Orthod. 2011;33(2):121–125.

Google Scholar

Heymann GC, Cevidanes L, Cornelis M, De Clerck HJ, Tulloch JF. Three-dimensional analysis of maxillary protraction with intermaxillary elastics to miniplates. Am J Orthod Dentofacial Orthop. 2010;137(2):274–284.

Google Scholar

10.

De Clerck H, Cevidanes L, Baccetti T. Dentofacial effects of bone-anchored maxillary protraction: a controlled study of consecutively treated Class III patients. Am J Orthod Dentofacial Orthop. 2010;138(5):577–581.