Abstract
Class III malocclusion associated with skeletal anterior open bite pattern in adults can be a challenging orthodontic problem, especially for the nonsurgical treatment. Conventionally, several treatment alternatives are available such as tooth extraction, molar intrusion, and absolute anchorage system or orthognathic surgical correction. Although correction with surgery may be the most effective and stable way, many patients refused surgical treatment plan because of the costs and traumas it may bring. We reported a nonsurgical orthopedic treatment of 22-year-old male with severe skeletal anterior open bite, dental Class III malocclusion, posterior crossbite and a high mandibular plane angle. The patient refused surgery and extraction. So we formulated a treatment plan consisting of using rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, Class III elastics to correct the canines, premolars, and molars relationship, reverse curve of the nickel-titanium wire combined with anterior vertical elastics to intrude molars and correct open bite. In this case, without suffering of surgery, the posterior crossbite was ideally corrected, and ideal overjet and overbite relationships and functional occlusion were all achieved. The patient obtained satisfactory occlusal as well as functional and stable results.
Highlights
The frequency of Class III malocclusions varies in dif-ferent racial groups
We reported a nonsurgical orthopedic treatment of 22year-old male with severe skeletal anterior open bite, dental Class III malocclusion, posterior crossbite and a high mandibular plane angle
We formulated a treatment plan consisting of using rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, Class III elastics to correct the canines, premolars, and molars relationship, reverse curve of the nickel-titanium wire combined with anterior vertical elastics to intrude molars and correct open bite
Summary
In Asians, it ranges from 4% to 14% and the etiology of this condition varies from one to another [1,2] It is combined with several other abnormalities such as anterior or posterior crossbites, retroclined mandibular incisors, proclined maxillary incisors, and functional slides from centric relation to centric occlusion. The following case report illustrates a nonsurgical, nonextraction treatment of a patient with Class III malocclusion associated with skeletal anterior open bite, posterior crossbite and a high mandibular plane angle. Because he refused surgery and extraction, the only mean we could use was molars intrusion. We used nickel-titanium wire with reverse curve and anterior vertical elastics to correct skeletal anterior open bite and obtained a functional and esthetic result
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