Introduction
The aim of this case report is to present a class III growth modification case managed with facemask therapy.
Diagnosis
- Skeletal :
- Sagittal: class III due to maxilla retrognathism and mandible prognathism
- Vertical: hypo-divergent
- Transverse: facial symmetry
- Dental:
- Bilateral molar class III when centric occlusion(CO)
- Teeth 15~26 / 45~36 lingual cross-bite when CO
- Proclined upper incisor (116.5°)
- Functional: centric relation(CR) and CO discrepancy
A 10-year-old girl came with chief complaint of anterior crossbite and mandible protrusion. She received treatment with 14, 24 extraction and upper incisor tipped-out by previous dentist. However, anterior crossbite correction couldn’t catch up with mandible growth and upper incisor already too proclined. Thus, she was referred to our department. Growth modification treatment with facemask was provided. The facemask design include 2 temporary anchored devices(TADs) near the center of resistance of maxilla. After 19-month treatment, the cephalometric measurement showed SNA improved from 78.5 to 84.5 degree, ANB improved from -5.5 to 0.0 degree and upper incisor inclination maintained. The facial results were favorable with an improved labial support and less concave lateral profile. Positive overjet and overbite was obtained by anterior protraction of the maxilla.
Conclusion
Growth modification treatment with facemask is a possible way to treat class III malocclusion adolescent especially in maxilla retrognathism. TADs helps to increase skeletal effect and decrease dental effect. This case was successfully treated with facemask therapy and TADs, which improve her lateral profile and achieve functional occlusion.