3.management of angles class iii malocclusion

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  • *Enlarged adenoids, other respiratory conditions
  • Mandible looses its posterior proprioceptive and functional support
  • skeletal open bite
  • Synergistic
  • 3.management of angles class iii malocclusion

    1. 1. MANAGEMENT OF ANGLES CLASS III MALOCCLUSION
    2. 2. What is Angle’s class iii? • This condition represents a prenomalcy where the mandible is in a mesial relation to the upper arch • According to angle, Class iii molar relationship refers to a condition where the mesiobuccal cusp of the upper 1st molar occludes between the mandibilar 1st and 2nd molars • The lower molar can be in the said mesial relationship to varying degrees
    3. 3. Features: Extra-oral Features • A straight to concave profile • Anteriorly divergent profile • Long face (increased lower face height), which may be pointed at the chin • Mandible appears to be well developed (with an obtuse gonial angle)
    4. 4. Features cont: Intraoral Features • A Class iii molar relationship • A Class iii canine relationship • A reverse overjet with possibly labially inclined lower incisors and lingually inclined upper icisors • A posterior cross-bite unilateral or bilateral (or functional) due to a constricted maxillary arch or a more forward positioned lower arch
    5. 5. Skeletal features: i. Short retrognathic maxilla ii. Long prognahtic mandible iii. combination
    6. 6. Etiology: • Hereditary (main factor) • Functional factors and soft tissues (Flat, low, anteriorly placed tongue that lies low in the oral cavity / macroglossia) • Compulsive habit of protruding the mandible • Unilateral or bilateral hyperplasia of mandibular condyle can cause the Class III malocclusion.
    7. 7. Etiology cont… • Occlusal forces created by the abnormal eruption may produce unfavorable incisal guidance • Premature loss of deciduous molars may also cause mandibular displacement with an occlusal guidance from teeth • Anteroposterior deficiency of the maxilla can occur in cases of cleft lip and palate • Trauma to the mid-face during the growth phase
    8. 8. Correction of class iii • Growth modification • Orthodontic correction • Surgery
    9. 9. • Should be identified and corrected early • Treatment is highly dependent on the patient’s age and hence; - Preadolescent - Adolescent - Adult
    10. 10. PRE-ADOLESCENT CHILD A) FRANKEL III APPLIANCE • Stretches the soft tissue envelop around the maxilla in an attempt to stimulate the forward growth of the maxilla. Does not allow the mandible to advance forward.
    11. 11. B) THE CHIN CUP • Applies forces, directed along the direction of growth of the condyle. Inhibits the forward growth of the mandible • Capable of moving the chin down and back.
    12. 12. C) ANTERIOR FACEMASK • Promotes maxilla to grow anteriorly and/or rotate downwards. This causes a reciprocal downward and backward rotation of the mandible.
    13. 13. D) RME WITH ANTERIOR FACEMASK • RME is used to split the mid-palatal suture causing a downward and forward movement of the maxilla. • During this instance the teeth are disoccluded. • A facemask is used to pull the maxilla further forward.
    14. 14. E) 3-D SCREWS • Capable of expanding the maxilla in all the three directions. • Appliances, both removable and cemented can be used to correct pseudo Class iii malocclusions and thus prevent their progression to a full-fledged malocclusion.
    15. 15. THE ADOLESCENT CHILD • Limited to orthodontic camouflage or orthodontic decompensation in an effort to prepare the patient for surgery. • Camouflage can be achieved by proclining the maxillary anteriors and tipping the mandibular incisors lingually • Single arch extractions, extraction only in the mandibular arch, are frequently done to create space for the retraction of the mandibular anterior segment
    16. 16. ADULTHOOD • Emphasis is more on orthognathic surgery. Bilateral sagittal split osteotomy with retraction of the mandible Segmental retraction
    17. 17. Thank You!

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