Tratamento da má oclusão de classe III na dentição mista: relato de caso Fortaleza

Abstract

A malocclusion may be present due to dental, skeletal or functional factors. In cases of Class III malocclusion it may be observed maxillary retrusion, mandibular protrusion or a combination of both conditions. Moreover, it may be associated with maxillary constriction, usually manifested as anterior or posterior crossbite, in one side or in two sides. The early treatment of Class III malocclusion may be considered a real challenge to Orthodontists due to its multifactorial etiology and the difficulties in craniomandibular growth pattern prediction. The early treatment has a notable advantage: maximizes the skeletal effects, reducing the need of treatment in permanent dentition, when orthodontic camouflage or surgical approach are the only options available. The purpose of this paper is to present a clinical report of a patient in early mixed dentition period with Class III malocclusion, treated by maxillary rapid expansion combined with reverse pull headgear. The patient presented a brachyfacial type, straight profile, maxillary retrusion, mandibular protusion, anterior and posterior crossbite. Rapid maxillary expansion was performed by using a Hyrax appliance, followed by Petit facemask therapy. After 15 months, a progeny appliance was installed. It was observed that the early approach was efficient to correct the Class III malocclusion, shown by an improvement of the maxilla-­ mandibular relation and the clinical results were considered very satisfactory.