Abstract
ABSTRACTIntroduction: The efficacy and efficiency of early treatment of skeletal Class III patients with facemask therapy are well-documented; however, very few cases for adolescents or adults were reported. Objective: The aim of this case report was to demonstrate skeletal and dental correction of a post-pubertal-growth-spurt patient whose malocclusion consisted of a skeletal Class III with slight transverse deficiency, a high mandibular plane angle, and a retrusive maxillary complex. Case report: A 13-year-5-months old Hispanic female was diagnosed as a retrognathic maxilla and mandible, a high mandibular plane angle, open bite pattern, a bilateral Angle Class I molar relationship with an anterior crossbite on the maxillary lateral incisors. A TAD-supported Haas rapid palatal expander was utilized for maxillary protraction combined with a facemask, vertical control, and maxillary molar distalization with fixed appliance. Results: The total treatment time was 26 months. An improved facial profile with maxillary lip support and more prominent cheeks was established. Adequate vertical control prevented a change in the mandibular plane angle even though facemask treatment can increase the vertical dimension. After the 18-month retention, excellent stability of the treatment results was shown. Conclusion: With skeletal anchorage and facemask treatment, orthodontists have the ability of expanding and protracting the maxilla without tipping maxillary molars buccally and without the risk of unfavorable periodontal consequences. A TAD-supported Haas rapid palatal expander allowed to control the vertical dimension and distalize molars, while minimizing undesired consequences.
Highlights
The efficacy and efficiency of early treatment of skeletal Class III patients with facemask therapy are well-documented; very few cases for adolescents or adults were reported. The aim of this case report was to demonstrate skeletal and dental correction of a post-pubertal-growth-spurt patient whose malocclusion consisted of a skeletal Class III with slight transverse deficiency, a high mandibular plane angle, and a retrusive maxillary complex
Case report: A 13-year-5-months old Hispanic female was diagnosed as a retrognathic maxilla and mandible, a high mandibular plane angle, open bite pattern, a bilateral Angle Class I molar relationship with an anterior crossbite on the maxillary lateral incisors
A TAD-supported Haas rapid palatal expander was utilized for maxillary protraction combined with a facemask, vertical control, and maxillary molar distalization with fixed appliance
Summary
The efficacy and efficiency of early treatment of skeletal Class III patients with facemask therapy are well-documented; very few cases for adolescents or adults were reported. Treatment should be carried out in patients less than 10 years of age to enhance the orthopedic effect.[1,2] there are some reports in the literature that there is no statistically significant difference between younger and older (> 10-year-old) children.[3,4,5,6] Discrepancy between the skeletal and chronological ages may be a factor, and it might be better to consider the skeletal age as a clinical indicator to determine the effectiveness of using a facemask.[7] even if correction can be achieved in all growing patients, the skeletal changes may be smaller in older children This case report demonstrates the efficacy of a TAD-supported Haas rapid palatal expander in conjunction with a facemask utilized for transverse correction, sagittal correction, and vertical control
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