TREATMENT of class III MALOCCLUSION (Karen McDonagh)

Although traditional orthodontic treatment of malocclusion of class developing, focused on the lower jaw as the primary cause of divergence, recent studies have suggested that 63% of skeletal class III malocclusion display maxillary retrusion. The majority of patients tend to expose a maxillary hypoplasia in conjunction with a normal mandible or slightly prognathic.

Unfortunately, I see too many young patients, for a second opinion, which said there was nothing the orthodontist can do but wait until the end of their facial growth, and knit their place for orthognathic surgery. However, most of the surgical procedures to correct the malocclusion of class involves maxillary advancement! This suggests that the problem has never been excessive mandibular growth, but rather a lack of development of the maxilla. These problems may result from blockages of the nasal passages, where the child was younger.

Orthodontic treatment for the malocclusion of class can be defined in the following categories:

1. Amendment of growth maxillary expansion and protraction face mask therapy

2. Modification of growth involving a chin strap to restrict mandibular growth, or

3. Wait until growth has ceased, thus committing the patient, to dental camouflage or orthognathic surgery.

In my orthodontic practice, children with early signs of a class III malocclusion are priority for treatment. My current treatment approach involves the protraction and development of the maxilla, but I don't use Chin cups because I believe that they have a negative effect on the temporo-mandibular joints of the patient.

Controversy exists about the best time to begin orthodontic treatment of class. Takada examined maxillary protraction therapy and reported that the pre-pubescent and mid-puberty time is preferable, due to the natural growth of the maxilla (stage C2 - C3).

GOALS OF TREATMENT FOR PATIENTS OF CLASS:

If we consider the patient at the beginning of the growth of the cycle as possible, i.e. as soon as the problem of class III can be diagnosed, can achieve the following treatment goals:

1 Reduce the growth of the size of the mandible.

2 Increase the size of the maxilla to its maximum potential of genetics, and

3. Move the upper jaw forward to its maximum potential of genetics.

A cephalometric analysis is required to confirm the diagnosis of the class III malocclusion and to formulate, either a surgical or non-surgical treatment plan.

Personally, I use the Jefferson cephalometric analysis as this is ideally suited for the correct diagnosis of a patient to class III. In the analysis of Jefferson the mandible size and position of the mandible can be easily related to the length and position of the anterior base of skull. The size of the maxilla and the position of the maxilla, could also be linked to the size and position of the anterior base of skull.

Jefferson cephalometric analysis is only a medium easy visual to identify the maxillary/mandibular disproportions

Karen McDonagh is proud authors and writes articles on several subjects, including dental courses. She is passionate about professional dental care and education seeking better ways to educate people always.
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