Interception of developing class III malocclusion with temporary anchorage devices: A case report

IntroductionClass III malocclusion is a result of maxillary deficiency, mandibular prognathism or a combination of both, often accompanied by an anterior crossbite and a concave profile.AimThe aim of this work was to report and analyze a case of class III malocclusion.Case studyThe patient, a 12-year-old boy, attended Maxillo-Facial Clinic with the complaint of his lower jaw being in front. The pre-treatment examination showed a slight flattened subnasal area and the reverse overjet. For the maxillary protraction, de Clerck method of bone anchors and class III elastics were applied. After previous palatal expansion, the bone-anchored maxillary protraction was applied. The surgery was performed under general anesthesia. The surgical procedure consisted in placing four miniplates – one in each infrazygomatic buttress of the maxilla, and one in the anterior mandible between, and inferior to the left and right permanent lateral incisor and canine. The miniplates were loaded 3 weeks after the surgical procedure. After 7 months of treatment, the anterior crossbite was corrected.Results and discussionCephalometric evaluation between the beginning of treatment and the end of maxillary protraction showed marked increase in ANB and Wits. A counterclockwise rotation of the mandible was observed, as well as a slight clockwise rotation of the maxillary bone. The obtained results correspond to de Clerck's cephalometric investigations in class III patients who were treated with the use of bone-anchored maxillary protraction.ConclusionsTemporary anchorage devices application enabled correction of the anterior crossbite and enhanced midfacial growth in young maxillary-deficient patient.