Protraction Facemask Followed by Mandibular Cervical Headgear: an Alternative in the Treatment of Class III Malocclusion with Severe Anterior Open-Bite

Matheus Pithon,Luiz Antonio Bernardes

doi:10.14295/bds.2021.v24i2.1953

Abstract

The present case report describes a conservative and uncommon treatment for class III malocclusion in a woman growing patient with aged eight years and four months. An unconventional treatment modality was used for the treatment of this malocclusion, reverse-pull headgear and distalisation of lower teeth using mandibular cervical headgear in the lower arch. At the end of the treatment (after 33 months), there was correction of the transversal and sagittal occlusal relationship between maxilla and mandible and correct dental intercuspation. Keywords Class III malocclusion; Open-bite; Orthodontics.

Highlights

The treatment of patients with class III malocclusions usually gives orthodontists a series of difficulties in reversing the condition
Protraction Facemask Followed by Mandibular Cervical Headgear: an Alternative in the Treatment of Class III Malocclusion with Severe Anterior Open-Bite elastics; [7,8,9] fixed appliance in association with a disjunctive appliance camouflaging malocclusion; [10,11] and even no treatment, in order to wait until puberty is complete to start a therapy aimed at performing orthognathic surgery in the future.[12,13]
In this search of a most effective treatment modality, we describe the treatment for class III malocclusion using reverse-pull headgear in the upper arch and an mandibular cervical headgear in the lower arch to distalise the lower teeth

Summary

INTRODUCTION

The treatment of patients with class III malocclusions usually gives orthodontists a series of difficulties in reversing the condition. [3,4,5] Various treatment protocols have been described in the literature for the treatment of this malocclusion These modalities include: maxillary disjunction followed by reverse-pull headgear (face mask) [6,7,8,9]; use of orthodontic anchor miniplates associated with intermaxillary. Protraction Facemask Followed by Mandibular Cervical Headgear: an Alternative in the Treatment of Class III Malocclusion with Severe Anterior Open-Bite a) e) Figure 7 (a-e) - Treatment stage with fixed appliance associated with mandibular cervical headgear with low traction in the lower arch. When the .20” steel archwire was positioned, the distalisation of the lower teeth started using the extra-oral appliance This appliance was adjusted in order to achieve distal movement with intrusive vector, because the patient had a vertical growth vector in which any extrusive movement could damage the final dental and facial result. Protraction Facemask Followed by Mandibular Cervical Headgear: an Alternative in the Treatment of Class III Malocclusion with Severe Anterior Open-Bite c) g)

DISCUSSION

CONCLUSIONS