Non-surgical alternative in the treatment of skeletal Class III problems.

The dental profession is not static, but dynamic. New research findings, along with medical and technological advances, necessitate constant re-examination of treatment philosophies and techniques. What were acceptable treatment techniques in the past may not necessarily be the most effective and best techniques for our patients today. Currently, many practitioners feel that the only treatment for the correction of a skeletal Class III abnormality is via orthognathic surgery in older patients. In some cases it may be the only treatment option. But in most cases today, there are more conservative, non-surgical treatment alternatives in correcting Class III problems in younger aged children. In treating facial-skeletal problems, it must be emphasized that the human face is a biological masterpiece of form and function. Its importance has been documented in arts and sciences since the beginning of modern civilization. It is important enough so that individuals who are blessed with attractive features are afforded greater opportunities in our society. Attractive faces are associated with intelligence, honesty and good work ethics. With the advent of orthognathic surgery, functional appliance, functional regulator, and myofunctional therapy, the dental profession has the capability of leveling out the playing field for many individuals in our society. It does so by being able to correct problems closely associated with the human psyche--the human face. The ability to change facial features brings tremendous prestige to our profession. Along with this prestige comes greater responsibility. Our ability to change facial features entails greater understanding of facial balance and harmony. Ricketts states that the face must conform to stringent proportions known as the "divine proportion" in order for it to be esthetically pleasing. Also, our ability to move facial-skeletal structures entails greater understanding of the biomechanics of the human face. Without this knowledge practitioners can cause iatrogenic problems, such as temporomandibular disorders. Conversely, correcting facial-skeletal abnormalities have been found to alleviate many medical problems, such as chronic headaches, neck-back-shoulder pain, respiratory disorders, auditory disorders, etc. As more and more information is gathered, it is becoming clear that the physical, emotional and psychological health of a human being is intimately related to craniomandibular anatomy. In fact, the jaw and dental structures (with the exception of the tooth enamel) is formed from the neural crest cells along with the endocrine system, while the central nervous system is formed from the neural tube. The entire nervous system, the endocrine system and the dental system are formed from common tissue origin. This can explain why many facial-skeletal corrections are often accompanied by alleviation of many medical and physiological problems. These are exciting times for our profession. However, if we wish to address the needs of our patients well into the next century, we must continue to seek greater and greater knowledge in the area of the craniomandibular anatomy relative to the rest of the human body. It has much to do with facial esthetics, physiologic and psychologic harmony, and TMJ health. This knowledge will enable our profession to have the power to change human lives in a very positive way. As doctors, there can be no greater personal and professional satisfaction than to realize that, through our professional intervention, we are able to offer our patients the possibility of achieving greater happiness and quality of life.