Introduction: This case report describes compensatory orthodontic treatment in a young patient aged 13 years. She presented with a class III skeletal malocclusion associated with mandibular laterognathy. The patient's main reason for consultation was the anterior cross bite and the aesthetics of her smile.
Materials and Methods: The chosen treatment was therefore an orthodontic camouflage with the extraction of the first mandibular premolars and the second maxillary premolars, in order to catch a correct anterior articular and restore a good occlusal relationship, however, the mandibular laterognathy was camouflaged by means of dental compensations and also by correcting the deviation of the incisors medians through a class III mechanics with good anchorage management.
Results: After 24 months of treatment, an ideal overjet and overbite associated with a Class I canine and molar relationship, was obtained, associated with a perfect coincidence of the interincisor medians.
Conclusion: Class III skeletal cases can often be treated either by orthodontic camouflage or surgery. In our case study, the treatment adopted was orthodontic camouflage with extractions. The results of the treatment were satisfactory and the occlusal objectives were achieved. The final harmonious smile pleased the patient and improved her self-esteem and quality of life.
Profitt W, Fields H, Moray L. Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg. 1998;13(2):97-106.
Ishii H, Morita S, Takeuchi Y, Nakamura S. Treatment of combined maxillary protraction and chicap appliance in severe skeletal class III cases. Am J Orthod Dentofacial Orthop. 1987 Oct;92(4):304-12. https://doi.org/10.1016/0889-5406(87)90331-3
Huh A, Horton MJ, Cuenco KT, Raoul G, Rowlerson AM, Ferri J, et al. Epigenetic influence of KAT6B and HDAC4 in the development of skeletal malocclusion. Am J Orthod Dentofacial Orthop. 2013;144 (4):568–76. https://doi.org/10.1016/j.ajodo.2013.06.016
Jacobson A, Evans WG, Preston CB, Sadowsky PL. Mandibular prognathism. Am J Orthod 1974;66:140–71. https://doi.org/10.1016/0002-9416(74)90233-4
Lin J, Gu Y. Preliminary investigation of nonsurgical treatment of severe skeletal Class III malocclusion in the permanent dentition. Angle Orthod. 2003 Aug;73(4):401-10. https://doi.org/10.1043/0003-3219(2003)073%3C0401:pionto%3E2.0.co;2
Ravi MS, Shetty NK, Prasad RB. Orthodontics-surgical combination therapy for Class III skeletal malocclusion. Contemp Clin Dent 2012;3(1):78–82. https://doi.org/10.4103/0976-237x.94552
Cassidy DW Jr, Herbosa EG, Rotskoff KS, Johnston LE Jr. A comparison of surgery and orthodontics in “borderline” adults with Class II, Division 1 malocclusions. Am J Orthod Dentofacial Orthop. 1993 Nov;104 (5):455-70. https://doi.org/10.1016/0889-5406(93)70072-v
Moullas AT, Palomo JM, Gass JR, Amberman BD, White J, Gustovich D. Nonsurgical treatment of a patient with a Class III malocclusion. Am J Orthod Dentofacial Orthop. 2006;129(4 Suppl):S111–S118. https://doi.org/10.1016/j.ajodo.2005.07.005
Hicham Benyahia, Mohamed Faouzi Azaroual, Claude Garcia, Edith Hamou, Redouane Abouqal, traitement des malocclusions de classe III squelettique : chirurgie orthognathique ou camouflage orthodontique, les facteurs décisionnels. Internatinal Orthodontics. 2011 ;9(2) : 196-209. https://doi.org/10.1016/j.ortho.2011.03.006
Eslami S, Faber J, Fateh A, Sheikholaemmeh F, Grassia V, Jamilian A. Treatment decision in adult patients with class III malocclusion: surgery versus orthodontics. Prog Orthod. 2018 Aug 2;19(1):28. https://doi.org/10.1186/s40510-018-0218-0
Rabie AB, Wong RW, Min GU. Treatment in Borderline Class III Malocclusion: Orthodontic Camouflage (Extraction) Versus Orthognathic Surgery. Open Dent J. 2008;2:38-48. https://doi.org/10.2174/1874210600802010038
Martinez P, Bellot-Arcís C, Llamas JM, Cibrian R, Gandia JL, Paredes-Gallardo V. Orthodontic camouflage versus orthognathic surgery for class III deformity : Comparative cephalometric analysis Int J Oral Maxillofac Surg. 2017 Apr;46(4):490-495. https://doi.org/10.1016/j.ijom.2016.12.001
Chen YJ, Yao CC, Chang ZC, Lai HH, Yeh KJ, Kok SH. Characterization of facial asymmetry in skeletal Class III malocclusion and its implications for treatment. Int.J.Oral Maxillofac Surg. 2019 Dec; 48(12):1533-1541. https://doi.org/10.1016/j.ijom.2019.06.014
Yu J, Hu Y, Huang M, Chen J, Ding X, Zheng L. A three-dimensional analysis of skeletal and 2 dental characteristics in skeletal class III 3 patients with facial asymmetry. J Xray Sci Technol. 2018;26(3):449-462. https://doi.org/10.3233/xst-17333
Thiesen G, Gribel BF, Freitas MP. Facial asymmetry: a current review. Dental Press J Orthod. 2015 Nov-Dec;20(6):110-25. https://doi.org/10.1590/2177-6709.20.6.110-125.sar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Elhajoubi L et al.