ClassIIIHistorically –mandibularoverdevelopmentCombinationRecentlyMaxillaryRetrusion (60%)Ant./Post.CrossbiteEllis E, McNamara JA. Components of adult Class III malocclusion. J Oral Maxillofac Surg 1984.Guyer EC, Ellis EE, McNamara JA, Behrents RG. Components of Class III malocclusions in juveniles and adolescents.Angle Orthod 1986.ETIOLOGY OFCLASS IIIMALOCCLUSION
3.5% US14%ChineseandJapaneseINCIDENCE3.4%IndianAst DB, Carlos JP, Cons NC. The prevalence and characteristics of malocclusion among senior highschool students inupstate New York. Am J Orthod 1965.Irie M, Nakamura S. Orthopedic approach to severe skeletal Class III malocclusion. Am J Orthod 1975.Kharbanda OP, Siddhu SS, Sundarum KR, Shukla DK. Prevalence of malocclusion and its trait in Delhi children. J IndianOrthod. Soc 1995.INCIDENCE
OrthodonticCamouflageOrthognathicsurgeryDistractionosteogenesisGrowthModificationTindlund RS. Orthopaedic protraction of the midface in the deciduous dentition. J Craniomaxillofac Surg 1989.TREATMENTOPTIONS
Current Txprotocol fororthopedicMaxillaryProtraction is bymeans of elasticFacemaskChin CupExpansionTurley, P.K.: Orthopedic correction of Class III malocclusion with palatal expansion and custom protractionheadgear, J. Clin. Orthod. 1988.Hideo, M.: Early application of chincup therapy to skeletal Class III malocclusion, Am. J. Orthod. 2002.Sakamoto M, Sugawara J, Umemori M, et al. Craniofacial growth of mandibular prognathism during pubertalgrowth period in Japanese boys – Longitudinal study rom 10 to 15 years of age. J Jpn Orthod Soc 1996
Physicalappearanceof the extra-oralapplianceSkin irritationfrom theanchoragepadPOORCOMPLIANCEof child to wearit, major problemassociated withfacemask therapySung, S.J. and Baik, H.S.: Assessment of skeletal and dental changes by maxillary protraction, Am. J. Orthod. 1998.PROBLEMS IN CONVENTIONAL THERAPY
NEED OF NEW APPLIANCEHence there was a need of another appliance to enhancethe patient compliance with much better biomechanicsPresent paper discussed the construction and clinicalprocedure of an intraoral fixed appliance for thetreatment of Class III malocclusion in young patientswithout relying on patient co-operation
Fixed Maxillary Appliance with soldered buccal arm onfirst molar band for Class TractionFixed Mandibular Appliance with welded buccal tubeon first molar band to headgear facebowA 0.045 inch headgear face bow with the outer bowsbent out for Class III elastic attachment with a solderedstop at terminal end on inner bowComponents ofModified Fixed Nanobite Tandem Appliance (MFNTA)
FIXED MAXILLARY APPLIANCESean Shih-Yao Liu, Hee-Moon Kyung and Peter H. Buschang.Continuous forces are more effective than intermittent forces inexpanding sutures. Eur J Orthod 2010.
FIXED MANDIBULAR APPLIANCE Veerendra Prasad, Vijay P. Sharma, PradeepTandon, Gyan P. Singh. A new fixed biteplane. Jof Clinical Orthod 2008.
Mechanism of action of MFNTASchematic representation of a line offorce through the center of resistance(CR) of maxilla, which will result in atranslatory movement of maxilla. Inthe long vertical dimension of Class IIIpatients, it is advisable to adjust theline of force ≤20° to the occlusalplane (OP) to prevent downwardrotation of mandible.
Mechanism of action of MFNTASchematic representation of a line offorce for Class III with flat mandibularplane; it is advisable to adjust the lineof force ≥25° to the occlusal plane(OP) which will result in downwardand forward movement (clockwise) ofmidface and dentition resulting indownward and backward rotation ofmandible.
A CLINICAL REPORT OF PEDIATRIC PATIENT WITH CLASS III MALOCCLUSION TREATEDBY MFNTAPretreatment patient photographs She and herparents werepsychologicallydepressed withher facialappearance andreverse bite
CONCLUSIONPre and posttreatment recordrevealed-significant skeletalimprovement,and markedimprovement infacial balance
Address forcorrespondenceDr. Prabhat K C,Assistant Professor,Department of Orthodontics,Dr. Z A Dental College,Aligarh Muslim University,Aligarh, India -202001.Email IDfirstname.lastname@example.orgModified FixedNanobite TandemAppliance (MFNTA)