Jha Awanindra K, Chandra Subhash
Department of Orthodontics, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Int J Clin Pediatr Dent. 2021 Mar-Apr;14(2):331-334. doi: 10.5005/jp-journals-10005-1752.
Skeletal class III malocclusion are the most challenging orthodontic problem to treat. Diagnosis and treatment in early stage was important to boost self-esteem of patient. Our aim was to correct skeletal relationship and anterior crossbite to enhance the growth of maxilla.
Class III malocclusion can be due to retrognathic maxilla, prognathic mandible or combination. Complexity of class III malocclusion depends upon abnormal growth pattern of maxilla and mandible. Maxilla growth ceases around 8-10 years and mandible continue till 16 years. Early intervention boosts self-esteem of the patient.
This case presents with clinical feature of retrognathic maxilla at the age of six years. The patient had concave profile with incompetent lips. The mentolabial sulcus was normal and obtuse nasolabial angle with high clinical Frankfurt mandibular angle (FMA). There was reverse overjet of 1 mm. Cephalometric analysis showed a class III skeletal pattern with retrognathic maxilla and orthognathic mandible with increase in lower facial height and increases in gonial angle. The rapid maxillary expansion (RME) with reverse pull face mask was planned. The expansion screw was activated to loosen the circumaxillary suture.
After active treatment anterior crossbite was corrected. The patient sagittal discrepancy was improved. Early mixed dentition period is the best time to begin class III treatment.
Early treatment with maxillary protraction and palatal expansion can correct most anterior-posterior skeletal discrepancy.
Jha AK, Chandra S. Early Management of Class III Malocclusion in Mixed Dentition. Int J Clin Pediatr Dent 2021;14(2):331-334.
骨性Ⅲ类错牙合畸形是正畸治疗中最具挑战性的问题。早期诊断和治疗对于提升患者的自尊心很重要。我们的目的是纠正骨骼关系和前牙反牙合,以促进上颌骨的生长。
Ⅲ类错牙合畸形可能是由于上颌后缩、下颌前突或两者兼有。Ⅲ类错牙合畸形的复杂性取决于上颌骨和下颌骨异常的生长模式。上颌骨的生长在8至10岁左右停止,而下颌骨则持续生长至16岁。早期干预可提升患者的自尊心。
该病例为一名6岁上颌后缩的临床患者。患者面部轮廓凹陷,唇部闭合不全。颏唇沟正常,鼻唇角钝,临床法兰克福下颌角(FMA)较高。存在1毫米的反覆盖。头影测量分析显示为Ⅲ类骨骼型,上颌后缩,下颌骨位置正常,面下1/3高度增加,下颌角增大。计划采用反向牵引面罩进行快速上颌扩弓(RME)。激活扩弓螺丝以松解上颌骨周围的缝线。
积极治疗后,前牙反牙合得到纠正。患者的矢状向差异得到改善。混合牙列早期是开始Ⅲ类错牙合畸形治疗的最佳时机。
早期采用上颌前牵引和腭部扩弓治疗可纠正大多数前后向骨骼差异。
Jha AK, Chandra S. 混合牙列期Ⅲ类错牙合畸形的早期管理。《国际临床儿科牙科学杂志》2021年;14(2):331 - 334。