Case Report: Non-Extraction Management for Class III Malocclusion
Abdalla Samir Nouh
Egyptian Atomic Energy Authority (EAEA), Nasr City, Cairo, Egypt.
*Abdalla Samir Nouh, Egyptian Atomic Energy Authority (EAEA), Nasr City, Cairo, Egypt.
Figure 1: Extra-oral and Intra-oral Pretreatment records.
Based on lateral cephalomerty readings and clinical examination, there were two treatment options either extraction of carious second premolar with its contralateral one and extraction of lower first premolar, or trying to not to extract and deferring second carious premolar restoration till observing lower arch levelling and alignment.
The treatment aimed to relief crowding, correcting anterior crossbite, achieve alignment and ending the case with class I molar and canine relationship without extractions.
The second option was done trying to avoid extraction of upper second and lower first premolars after obtaining consent from the patient on treatment plan.
Treatment was initiated by ROTH brackets by boding upper arch skipping the carious premolar, while lower arch was initiated with ‘‘driftodontics technique’’ (5) which is bonding the lower arch except the lower anteriors, to avoid flaring of lower incisors resulting in full anterior crossbite with using IPR every visit to relief crowding allowing self- correction by natural drift.
Levelling and alignment was achieved till 17x25 SS wire in the maxillary arch and 16x22 SS in mandibular arch. Class III elastics were used to retract lower arch. After successfully retracting lower arch by class III elastics and obtaining normal overjet, lower incisors were bonded and aligned with lower teeth.
The patient has ideal overjet and overbite with concident midline. Levelled upper and lower arches. Class I canine and molar relationship was achieved. The carious premolar was endodontically treated and restored with Zircon crown.
Extra-orally the patient has nice smile with straight profile and concident upper and lower lips.
The patient was highly satisfied by his new smile which is the main objective in any orthodontic and dental treatment as shown Fig. (2)
Ceph readings were corrected to nearly normal values as shown in table (1)
Figure 2: Extra-oral and Intra-oral Post-treatment records.
Table 1: pre and post ceph readings
Figure 1: Generated figures can be generated quickly, and pr results, but can be misleading or difficult to interpret.
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