Class III Orthopedic Treatment with Skeletal Anchorage
Pp. 116-150 (35)
Won Moon and Reena Khullar
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.
Class III, Orthopedic Correction, Micro-implants, Rapid Palatal
Expansion, Facemask, Maxillary Deficiency, Dental Compensation, MARPE.
UCLA School of Dentistry, Section of Orthodontics, CHS 63- 082, Box 951668, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA.