Correction of Class III malocclusion using Rapid Maxillary Expansion

This is the case report of an 8 year old female patient reported to the Department of Orthodontics, whosechief complaint was crooked teeth. The patient desired treatment for esthetic and functional reasons.

Extra oral examination :

  • Shape of head - mesocephalic
  • Facial profile - orthognathic
  • Facial divergence - straight
  • Inter labial gap - 3 mm
  • Naso labial angle - acute
  • Maxilla - retrusive

Intra oral examination :

- Number of teeth

graph_03

- Rotations

gra_03

- Crowding of lower anteriors

orthopre1 orthopre2 orthopre3

Maxillary arch: U shaped, average size, symmetrical, with rotations of teeth. 

Mandibular arch: U shaped, average size, symmetrical, with crowding of anterior teeth.

Arches in occlusion:

Antero-posterior relation:

  • Molar relation : right / left - Class I relation
  • Overjet - reversed
  • Anterior cross-bite present

Transverse relation:

  • Posterior cross-bite present
  • Midline shift to the right by 1 mm

Diagnostic records:

Study models
Radiographs:

  • Hand - wrist radiographs
  • Cephalometrics - Cephalometric analysis was done using Steiner's analysis, Mc Nawara's analysis, and Bjork's polygon.
  • Orthopantemograph (OPG)

orthoc1Diagnosis & treatment records : From the cephalometric analysis and study models, it was inferred that the patient had Class III jaw bases with Class I molar relation along with anterior and posterior cross-bite ( maxilla contracted ), with lower anterior crowding.

Treatment Objectives :

  • Cross-bite corrections (anterior and posterior)
  • De-rotation
  • Lower incisor de-crowding

orthopost1 orthopost2 orthopost3

Treatment plan :

  • Rapid maxillary expansion (RME) with extraoral traction (bonded type)
  • IInd phase levelling and aligning

orthoc2

The type of appliance used was fixed and the estimated duration of treatment was 3 years, with a 3 year retention period. The prognosis and stability after treatment was good.

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