Orthopedic and Nonsurgical Orthodontic Treatment of Adolescent Skeletal Class III Malocclusion Using Bone-Anchored Maxillary Protraction and Temporary Anchorage Devices: A Case Report.

This report describes the case of a 12-year-old female patient with a long mandible experiencing difficulty chewing with the right molar. Considering the age of the patient, bone-anchored maxillary protraction using four miniplates placed below the maxillary zygomatic arch and anterior symphysis of the mandible and Class III intermaxillary elastics were planned. After 12 months, orthodontic treatment was initiated. After extraction of the impacted maxillary right second premolar and mandibular right second primary molar, protraction of the mandibular right molars was performed using a miniplate placed on the anterior part of the mandible as an anchor. Miniscrews were placed in the left posterior part of the mandible to improve the molar relationship and correct the dental midline through distalization of the mandibular left posterior teeth. We reported successful sequential comprehensive nonsurgical treatment in an adolescent with skeletal Class III malocclusion.

Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion.

OBJECTIVE: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. METHODS: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. RESULTS: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. CONCLUSIONS: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.