Solving Class III Malocclusion with Anterior Openbite by Damon Q2｜【Chris Chang Ortho】CC801

[case report]
This presentation described a skeletal CIII case with anterior crossbite treated non-surgically with self-ligation system and other auxiliaries, including CIII elastics and BS screws. Distal tipping of L6s is a common side effect when reducing overjet with BS screws. Bond #38, 48 after the overjet has changed from -2mm to +1mm is the key.
本篇報告描述了一個CIII合併前牙錯咬的案例，透過自鎖式矯正系統和其他輔助工具，如CIII elastics和BS screws來矯正。L6的distal tipping是把下排牙齒往後拉時常見的副作用，關鍵是要等到overjet從-2mm轉到+1mm時，才黏上#38, 48的矯正器。

[@shajiwahab]

Question to the doctors who worked on this case? Did the BS screws fail at all during the entire length of the case? And if so how many times did you re-insert?

[@abelalbujar3324]

Un caso fantástico Dr. Chris

[@ChrisChangOrtho]

Thank you for your watching!

[@hadeelwalid7408]

Good job and great work but i have an inquiry,, how were you able to control the inclination of the lower anterior during the retraction since they had been already retroclined ?

[@tuanhoan25]

Thanks!

[@ChrisChangOrtho]

Grateful for your view! Thank you for being part of this journey.

[@huangjerry6435]

What the length of the screw?

[@ChrisChangOrtho]

2x12mm SS. Please get more information from orthobonescrew.com/products.html

[@sonamtsering915]

How did you control the intrusive component on lower posteriors ?

[@ChrisChangOrtho]

Following the correction of the overjet, we repositioned the L7 bracket and simultaneously bonded the L8 bracket. The orthodontic wire was then reverted to a Cu-NiTi wire to facilitate precise adjustment of tooth positions.

[@abdomagdy430]

Great work professor,
But i have an inquiry
Why not extracting L5s, this will give less space to close and may not need for the BS TADs?

[@toy3245]

Im not sure but it seems that extracting L7s provides more space for retraction and amelioration of the class III than L5s.

[@nabrasrozaaljabori1333]

exactly we need space to relief overjet ​@@toy3245

[@abdomagdy430]

@@toy3245 I agree, but it looks about 1/2 to 3/4 unit cl III

[@toy3245]

@@abdomagdy430 can you elaborate what are those types of class III ? Im not an ortho but Id love to be one day

[@ChrisChangOrtho]

We considered extracting the lower second molars (L7s) in cases that meet the following criteria: a Class III malocclusion without crowding in the anterior teeth, and the presence of lower third molars (L8s) to substitute for the L7s. Since the lower anterior teeth are initially retroclined, extracting the L7s instead of the lower second premolars (L5s) could prevent further more tipping of the lower anterior teeth.

[@toy3245]

Why bonding the L8 only when the overjet is fixed ?

[@sammathew8871]

To correct the distal tipping of 7

[@toy3245]

@@sammathew8871 thanks for the answer so if I understand well, the lingual tipping of L7 is corrected by being bonded to L8 ?
What is the link between L8 and the overjet correction ?

[@sammathew8871]

@@toy3245 yes cuz u need a source of anchorage for the correction..so here Anchorage is L8

[@thapsuw3753]

In my opinion, If L8 already bonded , it might cos L8 to Tipping too. So we could wait until overjet fixed and then bonded L8.

[@toy3245]

@@thapsuw3753 good point, I thought about that too but Im not sure (not an orthodontist), thank you !