Orthopedic Treatment of Skeletal Class III Malocclusions with Bone-borne Appliances
Lecture Description
Class III malocclusion is one of the most difficult malocclusions to treat for the orthodontist. Although the form of malocclusion appears from an early age, only the maxilla can be protracted to a certain degree; the mandible growth cannot easily be suppressed and only the vertical direction of the growth can be slightly changed. Even such orthopedic treatments are only effective under the ages of 10, when the circummaxillary sutures can be disarticulated. The cause of the malocclusion cannot be fully understood, and resolving the few known causes (e.g., heredity, rhinitis, etc.) is often very difficult. Even after the orthopedic treatment, these unblocked causes can lead to an unfavorable growth pattern for as long as the patient’s growth persists. Moreover, due to the cephalocaudal gradient law of growth, which states an increased, latter growth farther away from the head, treatment is inevitably prolonged as the mandible growth occurs until a later stage.
In the early stages of Class III malocclusion treatment, not only is it important to improve the morphology of the malocclusion, but relieving the factors causing the malocclusion is critical. If the underlying cause cannot be resolved, the overall prognosis would be very poor due to the subsequent unfavorable growth pattern no matter how effective the early treatment was.
Another important treatment goal to take into consideration along with the successful improvement of causative factors is to prolong the orthopedic effects until a later age. As previously described, it is often impossible to completely eliminate the underlying cause of the malocclusion-therefore, the treatment outcome depends on how long the orthopedic treatment can compensate for unfavorable growth. Recently developed skeletal-anchored appliances that delivers the orthopedic forces directly to the maxilla are utilized today in many forms to achieve this goal.
This presentation will discuss methods to alleviate the causative factors that can be applied in early treatment of class III malocclusion, and also address various ways to prolong the application of orthopedic forces until the later stage of growth.
October 28-30, 2022 ¡¤ COEX, Seoul, Korea