Early Treatment Of Class Ⅲ Malocclusion With RPE,Face Maskand Corrective Orthodontic

Introduction: Skeletal class Ⅲ malocclusion is a growth related facial profile deformity which increase if lated treatment.Although class Ⅲ malocclusion is very well studied in the past but still be the one of the most difficult to treat.Different aspects of this malocclusion such as its diagnosis and different treatment modalities are very well documented.On the other hand,mixed dentition period is the best timing for maxillary orthopedic treatment and growth modulation in Class Ⅲ malocclusions.Overall,skeletal growth ranged before growth spurt seems to be the ideal time for intervention in Class Ⅲ maxillary deficiency,the combining of face mask(FM)and rapid maxillary expander(RME)to modulate the craniofacial development and to improve a facial profile.Methods: This report describes the treatment of a 10-year-old male patient in a mixed dentition stage with Class Ⅲ molar relationship on Class Ⅲ skeletal pattern with concave profile,anterior crossbite and unilateral posterior crossbite on left side.The treatment consisted of 2 stages approach(interceptive and corrective)by using bonded RPE and Face mask in first stage and fixed orthodontic with straight wire technique in corrective stage.Results: The patient’s assessment at an interval of after bonded RPE,Face mask treatment and final treatment.The records showed a favorable growth of maxilla,and anterior crossbite improvement.Patient’s final examination revealed improvement in facial profile that become more convex.The relationship between maxilla and mandible revealed a forward movement of maxilla,restored to normality,canine and molar relationship.The SNA,ANB angle improved to normal value.Conclusion: Skeletal Class Ⅲ malocclusion with maxillary deficiency in a growing individual can be successfully managed by using the bonded RPE and follow by face mask.Thereby case selection carefully,patient cooperation,and the most importance is treatment ideal timing should be made towards an early correction of a developing class Ⅲ malocclusion(mixed dentition).Thus early skeletal class Ⅲ protraction face mask and bonded RPE treatment reduces the need for orthognathic surgery in future.