Utilising a Restorative Approach to Correct an Adult Skeletal Class III Malocclusion | New York, NY

Gerard J. Lemongello discusses all the steps taken to correct the malocclusion

Edward H. Angle described class III malocclusion as one in which the mandibular first molar is positioned mesially relative to the maxillary first molar (Angle 1900). A class III skeletal relationship can occur as a result of a normal maxilla with mandibular protrusion, maxillary retrusion with a normal mandible, or a combination of maxillary retrusion and mandibular protrusion. A class III dental relationship can exist when the maxillary/mandibular relationship is normal. A pseudo class III malocclusion is caused by a forward shift of the mandible to avoid incisal interferences (Proffit 1986). For many class III malocclusions, both surgical and orthodontic treatment are required. Depending on the amount of skeletal discrepancy, surgical correction may consist of mandibular retraction, maxillary protraction, or a combination of both procedures. For some minor class III malocclusions, or in the case of a pseudo class III malocclusion, surgical intervention may not be necessary.

Treatment objectives, whether utilizing surgery, orthodontic treatment, or restorative treatment, are the same: to correct the class III crossbite, create an ideal overjet/overbite relationship, achieve a dental class I occlusion, correct the occlusal/incisal plane, correct the midline, and restore the teeth to proper size and proportion. The objective is to provide the patient with an acceptable functional-occlusal relationship and an aesthetic dental/facial appearance.

Malocclusions are common. Patients with crowded and rotated teeth, spacing, or a crossbite who are unsatisfied with their appearance may not be interested in traditional orthodontic treatment or surgical correction. Their objections can be related to the length of time needed to complete treatment, or fear of extensive surgery with extended recuperation.

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