Abstract
ABSTRACT Introduction: Skeletal Class III malocclusion with asymmetry is one of the most difficult problems to correct in orthodontics. A functional shift of the mandible in growing patients may occur accompanying a Class III, due to constricted maxillary arch and occlusal interferences. Studies have indicated that posterior unilateral crossbite develops early and has a low rate of spontaneous correction. It may further lead to development of mandibular and facial asymmetry by growth and displacement of mandible if left untreated in growing patients. Objective: This article reports the clinical case of a thirteen-year-old female patient in CVMI transition stage that had maxillary hypoplasia with a developing facial asymmetry. Results: The case was successfully managed with bone-anchored facemask therapy and with elimination of occlusal interferences with guided occlusion. Reverse twin block in the retention phase maintained the results achieved. Conclusion: A four-year follow-up evaluation revealed successful maintenance of the treatment results.
Highlights
Skeletal Class III malocclusion with asymmetry is one of the most difficult problems to correct in orthodontics
Maxillary hypoplasia in anteroposterior direction in skeletal Class III malocclusion is often accompanied by transverse deficiency of maxilla.[1,2,3]
Functional condylar adaptation occurs in concordance with functional mandibular displacement, which may progress into morphologic asymmetry.[8,9,10]
Summary
Skeletal Class III malocclusion with asymmetry is one of the most difficult problems to correct in orthodontics. Maxillary hypoplasia in anteroposterior direction in skeletal Class III malocclusion is often accompanied by transverse deficiency of maxilla.[1,2,3] Due to the transverse constriction of maxilla, the occlusal interferences exist as the mandible closes into centric occlusion, resulting in functional shift of mandible to one side.[4,5] This leads to the development of a unilateral posterior crossbite. Studies have indicated that posterior unilateral crossbite develops early and has a low rate of spontaneous correction.[6,7] In addition, functional condylar adaptation occurs in concordance with functional mandibular displacement, which may progress into morphologic asymmetry.[8,9,10] Treatment of such a case is considered to be challenging, and it requires close observation, with accurate diagnosis and prompt intervention in growing age
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