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3.management of angles class iii malocclusion

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 3.management of angles class iii malocclusion Presentation Transcript

  • 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
  • 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)
  • 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
  • Skeletal features: i. Short retrognathic maxilla ii. Long prognahtic mandible iii. combination
  • 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.
  • 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
  • Correction of class iii • Growth modification • Orthodontic correction • Surgery
  • • Should be identified and corrected early • Treatment is highly dependent on the patient’s age and hence; - Preadolescent - Adolescent - Adult
  • 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.
  • 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.
  • C) ANTERIOR FACEMASK • Promotes maxilla to grow anteriorly and/or rotate downwards. This causes a reciprocal downward and backward rotation of the mandible.
  • 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.
  • 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.
  • 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
  • ADULTHOOD • Emphasis is more on orthognathic surgery. Bilateral sagittal split osteotomy with retraction of the mandible Segmental retraction
  • Thank You!