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Main Instructor Wei-Yung Hsu
Chen-Jung Chang
Jen-Bang Lo
Department / Institution Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan
Classification Case report
  Class III malocclusion could be a result of mandible prognathism, maxilla retrognathism or combination of both. Growth modification with facemask and rapid palatal expansion (RPE) could be a treatment option. This case report presents the treatment of a growing patient with skeletal class III malocclusion combined with premolar impaction.
  A 10-year-old boy had chief complaints of anterior crossbite and tooth impaction. The cephalometric analysis revealed skeletal Class III, orthodivergent facial pattern with maxilla deficiency. In intraoral examination, tooth 25 impaction was noted. We upright his upper first molars with the pendulum appliance, and the facemask combined with RPE is for his narrow and retrusive maxilla. After treatment, we created space for tooth 25 eruption, and improved the retrusive and constricted maxilla. No CO-CR discrepancy was noted and occlusion is stable. Considering the late growth of mandible, we decided to follow up mandible growth and keep the facemask for retention.
<Discussion and Summary>
  Treatments for preadolescent Class III malocclusion including facemask, functional appliance, and so on. For a growing patient with sagittal and transverse problems, facemask combined with RPE treatment could be an option. Maxillary premolar impaction could be a result of the early loss of primary molar. Methods to upright the molar could be fixed or removable appliances. The pendulum appliance is a choice for patient with poor compliance.

Growth Modification for A Preadolescent Patient with Skeletal Class III Malocclusion and Premolar Impaction