Class III Orthopedic Treatment with Skeletal Anchorage

Class III malocclusion has been treated in the past using several different approaches. In growing patients, appliances such as the chin cup and facemask, with or without palatal expansion, have been used for orthopedic correction. Whereas the chin cup has been used to restrain or change the direction of mandibular growth, the facemask has been used to protract the maxilla. The traditional approach of facemask treatment with expansion involves using the maxillary dentition as an anchorage unit. This invariably results in an increase in the vertical dimension of occlusion, due to the buccal tipping and extrusion of the maxillary dentition as well as an increase in incisor inclination, due to the forward movement of maxillary dentition. In Class III high angle cases, both the transverse and anterior movements can cause tipping of the dentition which tends to open the bite; thus, controlling the vertical dimension is of utmost importance during the treatment phase. The aim of this chapter is to introduce a novel approach, using a combination of micro-implants with a rapid palatal expander, and a facemask. This approach skeletally expands and protracts the maxilla, leading to an almost negligible change in vertical dimension, an elimination of adverse dental movements, and a significantly positive change in the patient’s facial profile.

Keywords: Class III, Orthopedic Correction, Micro-implants, Rapid Palatal Expansion, Facemask, Maxillary Deficiency, Dental Compensation, MARPE.