Class III treatment with occlusal plane reconstruction – clinical case

Abstract

Introduction: The therapeutic approach of anterior open bites and class III is a challenge in orthodontic treatment, especially when it is performed without Orthognathic Surgery. Several treatment modalities for this type of malocclusion have been proposed over the years, such as Kim’s proposed Multiloop Edgewise Arch Wire (MEAW) technique, which was described 20 years ago [1,2]. The objective of this study is to present a clinical case of anterior open bite and skeletal class III, whose clinical approach consisted of the use of three plane arches with the same principle of the technique previously described. Materials and methods: A 29-years-old male patient came to Egas Moniz orthodontic clinic with the main complaint “I know I have a jaw problem and I want to treat it” SIC. In clinical and radiographic analysis, an anterior open bite, skeletal class III, and transverse dimension reduction were diagnosed. After obtaining informed consent, the treatment consisted of the use of fixed bimaxilar apliance with modified arches in the lower jaw, straight arch in the upper jaw and intermaxillary elastics (3/16 6oz). Results: Following the proposed treatment plan, it was possible to close the anterior open bite by promoting the intrusion and upright of the posterior mandibular teeth, alteration of the occlusal plane and a slight extrusion and retroinclination of the anterior teeth. Discussion and conclusions: The three plane arches technique presents the same principles of the MEAW technique since they incorporate tip-back bends that promote intrusion forces in the posterior and anterior teeth. The elastics used between the upper canines and the lower canines promote an anterior extrusion force and enhance the forces of the arch that promote intrusion of the posterior teeth [3,4]. Using this technique, it was possible to obtain satisfactory results and long-term stability in orthodontic treatment without orthognathic surgery. Figure 1. Initial Intraoral photos and x-rays. Figure 2. Final Intraoral photos and x-rays.