Class3malocclusion

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management of class 3 malocclusion

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Class3malocclusion

  1. 1. Class III Malocclusion
  2. 2. <ul><li>Def : According to Angle s classification a class III malocclusion exhibits mesiobuccal cusp of the maxillary permanent first molar occluding in the interdental space between mandibular first and second molars. </li></ul>
  3. 4. Classification of Class III Malocclusion
  4. 5. <ul><li>1 - True Class III : A skeltal Class III malocclusion which can arise form the follwowing reasons </li></ul><ul><li>Skeletal features : </li></ul><ul><li>Enlarged or forwardly positioned mandible </li></ul><ul><li>Short or backwardly positioned maxilla </li></ul><ul><li>A combination of both of these conditions </li></ul><ul><li>Dental Features : </li></ul><ul><li>Lingually tipped lower anteriors </li></ul><ul><li>Anterior crossbite / edge to edge incisor relationship </li></ul><ul><li>As the tongue occupies a lower position in the oral cavity due to the enlarged mandible the maxillary arch becomes narrow </li></ul><ul><li>Sot tissue features : </li></ul><ul><li>A concave profile and a posterior divergent face </li></ul>
  5. 6. <ul><li>2 - Pseudo Class III Malocclusion : </li></ul><ul><li>A class III malocclusion which is produced as a result of forward repositioning of the mandible during jaw closure is called postural/ habitual class III malocclusion </li></ul><ul><li>Etiology : </li></ul><ul><li>Premature loss of deciduous teeth motivates the patient to protrude the mandible in order to establish a contact in anterior region </li></ul><ul><li>Enlarged adenoids causes the patient to move the mandible forward to prevent the tongue from contacting the adenoids which causes pain </li></ul><ul><li>The most common cause for pseudo Class III malocclusion is the presence of Occlusal prematurities </li></ul>
  6. 7. <ul><li>3 - Class III Subdivision : </li></ul><ul><li>This is a condition characterized by a class III molar relationship one side and a class I relationship on the other side </li></ul>
  7. 8. Management of Class III Malocclusions
  8. 9. <ul><li>Management of Pseudo Class III malocclusion : </li></ul><ul><li>1) Removal of cause : Correction of occlusal prematurities ,Prosthetic replacement of missing teeth and correction of enlarges adenoids </li></ul><ul><li>Management of True Class III malocclusion : </li></ul><ul><li>Young patient : </li></ul><ul><li>1) Use of orthopaedic appliances such as a face mask and chin cup to initiate maxillary protrusion and mandibular restriction </li></ul><ul><li>A) Face Mask B) Chin Cup </li></ul>
  9. 10. <ul><li>2) Use of myofuctional appliances such a Frankel III appliance , Reverse Bionator etc. </li></ul><ul><li>A) Frankel III B)Reverse Bionator </li></ul><ul><li>3) Use of palatal expanders in order to correct the cross bite .Rapid palatal expansion can be performed in young patients </li></ul><ul><li>c) Quad helix </li></ul>
  10. 11. <ul><li>Adult patient : </li></ul><ul><li>1) Extractions: The lower first premolars are inadvertently extracted in order to retract the lower anterior teeth and correct the anterior cross bite. Use of class III elastics in order to attain the proper molar and canine relationship . </li></ul><ul><li>2) Surgical correction : Maxillary advancement in case of a short maxilla or Mandibular set back for enlarged mandible or a combination of both. </li></ul><ul><li>3) Use of palatal expanders to achieved maxillary arch expansion in cases of cross bite . Slow palatal expansion is indicated in such conditions </li></ul>
  11. 12. <ul><li>CASE I </li></ul>
  12. 13. <ul><li>PRE TREATMENT PHOTOGRAPHS </li></ul>
  13. 14. PRE TREATMENT -EXTRA ORAL PHOTOGRAPHS
  14. 15. PRE TREATMENT INTRA ORAL PHOTOGRAPHS
  15. 17. <ul><li>PRE TREATMENT MODELS </li></ul>
  16. 20. <ul><li>PRE TREATMENT RADIOGRAPHS </li></ul>
  17. 21. PRE-TREATMENT RADIOGRAPHS
  18. 22. <ul><li>MID-TREATMENT PHOTOGRAPHS </li></ul>
  19. 23. MID-TREATMENT INTRA ORAL PHOTOGRAPHS
  20. 24. <ul><li>POST- TREATMENT PHOTOGRAPHS </li></ul>
  21. 25. POST-TREATMENT EXTRA ORAL PHOTOGRAPHS
  22. 26. POST-TREATMENT INTRA ORAL PHOTOGRAPHS
  23. 28. <ul><li>POST TREATMENT MODELS </li></ul>
  24. 31. <ul><li>POST TREATMENT RADIOGRAPHS </li></ul>
  25. 32. POST TREATMENT LATERAL CEPH
  26. 33. <ul><li>Comparative </li></ul>
  27. 34. Bo ahead of AO by 4mm BO ahead of AO by 8 mm Wits appraisal 1 0 -2 0 ANB Post Rx Pre Rx Mean Cephalometric Parameter 131mm 132mm Mandibular Length 101mm 97mm Maxillary Length 88 8 96 0 IMPA
  28. 35. <ul><li>POST RETENTION PHOTOGRAPHS </li></ul>
  29. 36. POST RETENTION EXTRA ORAL PHOTOGRAPHS
  30. 37. POST RETENTION INTRA ORAL PHOTOGRAPHS
  31. 39. <ul><li>POST RETENTION RADIOGRAPHS </li></ul>
  32. 41. PRE POST POST RETENTION
  33. 42. PRE POST POST RETENTION
  34. 44. <ul><li>CASE - 2 </li></ul>
  35. 45. <ul><li>PRE TREATMENT PHOTOGRAPHS </li></ul>
  36. 46. PRE TREATMENT EXTRA ORAL PHOTOGRAPHS
  37. 47. PRE TREATMENT INTRA ORAL PHOTOGRAPHS
  38. 49. <ul><li>PRE TREATMENT MODELS </li></ul>
  39. 50. <ul><li>PRE TREATMENT RADIOGRAPHS </li></ul>
  40. 51. PRE TREATMENT RADIOGRAPHS
  41. 52. <ul><li>MID- TREATMENT </li></ul>
  42. 53. MID TREATMENT INTRA ORAL PHOTOGRAPHS
  43. 55. <ul><li>POST TREATMENT PHOTOGRAPHS </li></ul>
  44. 56. POST TREATMENT EXTRA ORAL PHOTOGRAPHS
  45. 57. POST TREATMENT INTRA-ORAL PHOTOGRAPHS
  46. 59. <ul><li>POST TREATMENT MODELS </li></ul>
  47. 60. <ul><li>POST TREATMENT RADIOGRAPHS </li></ul>
  48. 61. POST TREATMENT LATERAL CEPH
  49. 62. <ul><li>Comparative </li></ul>
  50. 63. mm Mm Wits appraisal 2 0 -4 0 ANB Post Rx Pre Rx Mean Cephalometric Parameter 132mm 116mm Mandibular Length 98mm 80mm Maxillary Length 76 0 80 0 IMPA
  51. 64. PRE POST
  52. 65. PRE POST
  53. 67. <ul><li>Case - 3 </li></ul>
  54. 68. <ul><li>PRE TREATMENT PHOTOGRAPHS </li></ul>
  55. 69. PRE TREATMENT EXTRA ORAL PHOTOGRAPHS
  56. 70. PRE TREATMENT INTRA ORAL PHOTOGRAPHS
  57. 72. <ul><li>PRE TREATMENT MODELS </li></ul>
  58. 74. <ul><li>PRE TREATMENT RADIOGRAPHS </li></ul>
  59. 75. PRE TREATMENT LATERAL CEPH
  60. 76. <ul><li>MID TREATMENT PHOTOGRAPHS </li></ul>
  61. 77. MID TREATMENT INTRA ORAL PHOTOGRAPHS
  62. 79. <ul><li>POST TREATMENT PHOTOGRAPHS </li></ul>
  63. 80. POST TREATMENT EXTRA ORAL PHOTOGRAPHS
  64. 81. POST TREATMENT INTRA ORAL PHOTOGRAPHS
  65. 83. <ul><li>POST TREATMENT MODELS </li></ul>
  66. 86. <ul><li>POST TREATMENT RADIOGRAPHS </li></ul>
  67. 87. POST TREATMENT RADIOGRAPHS
  68. 88. SUPERIMPOSITION
  69. 89. <ul><li>Comparative </li></ul>
  70. 90. 2mm 7mm Wits appraisal 1 0 -2 0 ANB Post Rx Pre Rx Mean Cephalometric Parameter 112.5mm 109mm Mandibular Length 91mm 85mm Maxillary Length 81 0 85 0 IMPA
  71. 91. <ul><li>POST RETENTION – 6 MONTHS </li></ul>
  72. 92. POST RETENTION EXTRA ORAL PHOTOGRAPHS CHIN CUP
  73. 93. POST RETENTION INTRA ORAL PHOTOGRAPHS
  74. 95. <ul><li>POST RETENTION – 1 YEAR </li></ul>
  75. 96. POST RETENTION EXTRA ORAL PHOTOGRAPHS
  76. 97. POST RETENTION INTRA ORAL PHOTOGRAPHS
  77. 99. <ul><li>POST RETENTION - 2 YEARS </li></ul>
  78. 100. POST RETENTION INTRA ORAL PHOTOGRAPHS
  79. 102. PRE POST POST RETENTION
  80. 103. PRE POST POST RETENTION

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