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The Indian Dental Academy is the Leader in

continuing dental education , training dentists

in all aspects of dentistry and offering a wide

range of dental certified courses in different

formats.

Indian dental academy provides dental crown &

Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit

www.indiandentalacademy.com ,or call
0091-9248678078

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Treatment of class iii malocclusion /certified fixed orthodontic courses by Indian dental academy Presentation Transcript

  • 1. TREATMENT OF CLASS III MALOCCLUSION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. “Class III malocclusion occurred when the lower teeth occluded mesial to their normal relationship the width of one premolar or even more in extreme cases”. - Angle (1899) www.indiandentalacademy.com
  • 3. CLASSIFICATION • TWEED (1966) CLASS III MALOCCLUSION PSEUDO CLASS III SKELETAL CLASS III Normal Mandible Large Mandible Underdeveloped Maxillae Underdeveloped or Normal Maxillae www.indiandentalacademy.com
  • 4. •MOYERS ACCORDING TO THE CAUSE : Osseous Muscular Dental Anterior Positioning : Tooth contact relationship which force the mandible into a forward position.(Pseudo Class III) www.indiandentalacademy.com
  • 5. • FREQUENCY OF CLASS III MALOCCLUSION 7 to 13 Years 1) Caucasians 1 to 4 % 14 to 18 Years 2) African – Americans 3) Asian 4.2% 5 to 8% Maxillary deficiency 4) Japanese 4 % Younger / 14 % Older 5) Chinese 3 % Younger / 13 % Older www.indiandentalacademy.com 9.4%
  • 6. ETIOLOGY  McGuigan (1966) – Inheritance of class III malocclusion in Hapsburg Family, having the distinct characteristics of prognathic lower jaw.  Litton et al (1970) – Dental characteristics of class III are related to genetic inheritance.  Functional factors – Anteriorly positioned tongue believed to be a local epigenetic factor.  Mental diseases – Compulsive habits of www.indiandentalacademy.com protruding the mandible.
  • 7. Enlarged tonsils and naso-respiratory diseases – Results in anterior tongue posturing. Premature loss of decidious molars – Results in anterior mandibular displacement. Tongue thrusting habit – Prevents eruption of buccal segments, thus causing auto-rotation of mandible into excessive intra occlusal space. www.indiandentalacademy.com
  • 8. COMPONENTS OF CLASS III MALOCCLUSION • Vertical components : • Vertical Deficient • Vertical Normal • Vertically excess •Anterio Posterior components : • Maxillary Deficient • Mandibular excess • Combined Maxillary deficient and mandibular excess www.indiandentalacademy.com
  • 9. DENTAL ASSESSMENT FOR DIAGNOSING CLASS III MALOCCLUSION www.indiandentalacademy.com
  • 10. Class III Skeletal Growth Pattern 1) Cranial Base  Angle – More Acute  Middle Cranial Fossa  Posterior and Superior Alignment 2) Maxilla  Decreased horizontal maxillary growth when compared with the patients with class I malocclusion. 3) Mandible  Gonial Angle  Obtuse  Anteriorly placed  Dentoalveolar compensation  Proclination of upper incisors, Retroclination of lower incisors. www.indiandentalacademy.com
  • 11. Indication and Contraindication for Early Class III treatment TURPIN et al (1981) Positive Factors : Good Facial esthetics Mild skeletal disharmony No familial prognathism Ant-Post functional shift Convergent facial types Negative Factors : Poor facial esthetics Severe skeletal disharmony Growth complete www.indiandentalacademy.com
  • 12. Treatment of Pseudo class III Malocclusion Clinical Features :  Anterior cross bite with premature tooth contact with CO-CR discrepancy Treatment : 1) Reverse SS crown 2) Tongue Blade 3) Fixed Appliance www.indiandentalacademy.com
  • 13. Treatment of Skeletal class III malocclusion 1) Pre-Adolescence (Growth Remaining) a) Functional Appliance Therapy  Frankel III regulator Two separate studies concluded ; 1) Dento alveolar effect 2) Downward and Backward rotation of Mandible www.indiandentalacademy.com
  • 14. CHIN CUP THERAPY  Indication  Normal maxilla and prognathic mandible  Effect of Mandibular growth • Redirection of Mandibular growth vertically • Backward repositioning of mandible • Remodeling of mandible with closure of gonial angle.  Effect of Maxillary Growth www.indiandentalacademy.com
  • 15. Force magnitude and Direction TYPES • Occipital Pull • Vertical Pull Orthopaedics force of 300-400 grams / 14 hours a day. Treatment Timing Primary to early mixed dentition Stability Sugarwara et al :- Though skeletal changes were greatly improved initially they were however not www.indiandentalacademy.com maintained.
  • 16. FACE MASK THERAPY Delaire et al , (1960) : Revived interest in using face mask for Maxillary protraction Petite : Later modified Delaire’s concept by increasing the force and thus decreasing the treatment time. www.indiandentalacademy.com
  • 17. COMPONENTS Forehead Pad Midline frame work Hooks Chin Pad www.indiandentalacademy.com
  • 18. Maxillary protraction below centre of resistance produces anticlockwise rotation of the maxilla Protraction elastics attached near the maxillary canine with a downward and forward pull of 30 degrees to the occlusal plane minimize bite opening. Force : 300 to 600 grams per side depending on age. Time : 10 to 12 Hrs / Day Duration : 3 to 6 months www.indiandentalacademy.com
  • 19. CONSTRUCTION OF ANCHORAGE SYSTEM 1) Metallic banded palatal expansion appliance 2) Acrylic bonded palatal expansion appliance Skeletal Effect of Maxillary Protraction Lacrimo Maxillary Fronto maxillary Naso Maxillary Ethmomaxillary Zygomatico maxillary Zygomatico Temporal Pterygo palatine Intermaxillary www.indiandentalacademy.com
  • 20. Cokish and Shapio ( 1979) :- - Anticlockwise maxilla - Clockwise rotation of mandible Kambala et al (1977) : Maxilla displaced anteriorly with changes in the circum maxillary sutures with forward and downward movement of maxilla Does it make a different if protraction was initiated during expansion or after expansion ? Beik (1984) : Found that greater forward movement of maxilla was initiated during maxillary expansion STABILITY : - Effects on maxilla remain stable for 1 – 2 years after treatment - In some studies maxilla and mandible reverted back to original position. www.indiandentalacademy.com
  • 21. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com