The Orthodontic Treatment Of The Skeletal Class Ⅲ Malocclusion With Mandibular Asymmetry

Objective: To explore the skeletal class III malocclusion with mandibular asymmetryorthodontic clinical effect of concealing treatment.Materials and methods:Choose a19year old female patient of the skeletal class IIImalocclusion with mandibular asymmetry deformity,come at June of2013in the FirstAffiliated Hospital of Dalian Medical University.The patient with concaveprofile,mandibular protrusion, maxilla develop over than mandible and the mandibularskewed to the right,12and42,43anterior teeth crossbite with open bite,13and44on,41,11and31edge to edge.Molar relationship is classsIII tip to tip; the Spee curve isflat. The mandibular midline is2.5mm right side relative to the face midline; upper andlower dental arch slight congestion;The patient denied facial tumor, trauma, diseasehistory.her mother is concave profile, anterior crossbite.With the model, lateralcephalograms, panoramic radiographs, skull radiographs and the soft tissue of thephoto analysis， confirm the diagnosis scheme.Orthodontic treatment by edgewiseorthodontic treatment combined with straight wire.After straight wire leveling andalignment, replacing forced MEAW wire,with different stages of vertical traction,midline traction and short III class traction,adjust the occlusal relationship.Results: After21months of treatment, the patient’s anterior teeth set up normaloverbite and overjet, molar and canine relationship achieve to classI, lower midlinecompared with before treatment to the leftside2mm, a good occlusal relationship isestablished. Analyzed the hard tissue before and after treatment: the maxilla andmaxillary teeth axis in the three-dimensional direction unchanged; mandible havevery significant changes, SNB decreased2.5o, wits values decreased8.5mm, B to FHV in vertical distance decrease3mm; L1-NB is reduced from23°to19o, L1-MPreduced by86o to83o, illustrate the mandibular incisors compensatory more lingualinclination.Analysis of the soft tissue before and after treatment:The mandibularprognath is improved,the sutface change from the origine concave surface to a nearlystraight surface. Front view of a certain improvement in patients with mandibulardeviation degree. Patients and their parents are satisfied with the results.Conclusion: Using the multiloop edgewise technique on skeletal class III malocclusionpatients with mandibular asymmetry by orthodontic camouflage treatment, patientsreturned to normal occlusion, overbite, overjet,mola rand canine reach a neutralrelationship.Soft tissue facial pattern has improved, especially the profile improvedsignificantly;Although patients with mandibular deviation level to a great improvement,but still did not achieve complete correction。Explain that using MEAW technology onskeletal mandibular asymmetry orthodontic camouflage treatment, teeth and alveolarbone change a lot,at the same time the bone changes very slightly.