TREATMENT of class III malocclusions (Karen Mcdonagh)

Although traditional orthodontic treatment, to develop class malocclusion, concentrated on the lower jaw as the primary cause of inconsistency, a recent study showed that 63% of skeletal class III malocclusions display the maxillary retrusion. Most patients tend to exhibit the maxillary hypoplasia with normal or mildly prognathic mandible.

Unfortunately I see too many young patients for a second opinion, which said that there is nothing to do but orthodontist can wait for their personal growth and then work for orthognathic surgery. Nevertheless, most surgical procedures to correct the bite class are the maxillary achievements! This shows that the problem has never been the excessive growth of the mandible, but rather a lack of development of the upper jaw. Such problems can caused by nasal blockages when the child was younger.

Orthodontic treatment for malocclusion class can be defined as follows:

1. Growth modification involving the maxillary expansion and protraction therapy facial mask

2. Growth modification with Chin Cup for controlling the growth of the mandible, or

3. Wait until the growth stopped, therefore, commitment to patient dental camouflage or orthognathic surgery.

In my orthodontic practice early signs of class III malocclusion in children, receive priority for treatment. My current approach of treatment involves inhaling and the development of the upper jaw, but I do not use Chin cups, as I feel that they have a negative impact on the patient, TMJ joint.

Currently exist regarding the optimal time to begin orthodontic treatment of class. Takada maxillary protraction therapy were studied and reported that the timing of the immature and the middle of pubertal better, due to the natural growth of the upper jaw (stage C2-C3).

THE GOAL OF TREATMENT FOR THE PATIENT:

If we treat the patient as early in the growth cycle as possible, i.e. as soon as can be diagnosed the problem of class III can be achieved following treatment goals:

1. the decline in the growth of the lower jaw.

2. increase the size of the upper jaw to the maximum genetic potential, and

3. move the jaw forward maximum genetic potential.

Cephalometric analysis is important to confirm the diagnosis of class III malocclusion and formulate a plan of surgical or non-surgical treatment.

I personally use the cephalometric analysis of Jefferson, as it's perfect for a proper diagnosis of the patient class III. In the analysis of the mandible size and Jefferson position the mandible can be easy with the length and position of anterior cranial base. Upper jaw size and the position of the upper jaw, may also be related to the size and position of the anterior cranial base.

Jefferson cephalometric analysis provides easy visual tools to detect the maxillary/mandibular imbalance

Karen Mcdonagh is proudly sponsoring and writes articles on several subjects including dental courses. She is passionate for dental education professional and always looking for better ways to educate people.
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