Nonsurgical treatment of an adult with skeletal Class III malocclusion, posterior crossbite and mandibular asymmetry

Abstract

Class III malocclusion represents a very heterogeneous clinical condition that is characterized by the combination of a wide variety of skeletal and/or dental components. Given the wide diversity, diagnosis and treatment of such malocclusion has always been a challenge for clinicians. Despite the different treatment options available, the treatment approach in the adult patient must depend fundamentally on the patient's decision, guided by the orthodontist and the maxillofacial surgeon. This case report presents the treatment of a patient with Class III malocclusion, with posterior crossbite and anterior edge-to-edge bite with fixed appliances and skeletal anchorage, an interdisciplinary, nonsurgical approach for a skeletal malocclusion. Firstly, to improve the posterior transverse relationship a band-soldered compressed lingual arch was cemented to the mandibular first molars. Then, once a correct transverse relationship was achieved, two miniscrews were placed distal to the mandibular second molars to distalize the whole mandibular arch, and avoid excessive inclination of maxillary incisors to improve dentofacial esthetics. At the end of the treatment, all the objectives planned at the beginning had been achieved and remained stable after the retention period. Key words:Clase III, orthodontic treatment, distalizing, appliances, posterior crossbite.