DEPARTMENT OF ORTHODONTICS

2. CLASS III
MALOCCLUSION
Dr.Panjami marish
Reader
Dept of orthodontics and dentofacial orthopedics

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Edward Angle classified malocclusion in 1899 based on
anteroposterior relationship of the jaws with each other as –
CLASS I CLASS II CLASS III

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CLASS III MALOCCLUSION
 Prenormal occlusion or
mesioclusion
 The mesial groove of
mandibular first permanent
molar articulates anteriorly to
the mesiobuccal cusp of
maxillary first permanent
molar

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1.True or skeletal class III
▪ Prognathic mandible
▪ Retrognathic maxilla
▪ Combination
CLASSIFICATION
A] Angle classified –

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2. Pseudo or functional or postural class III
▪ Occlusal prematurities
▪ Premature loss of deciduous posteriors
▪ Enlarged adenoids
3. Class III , Subdivision
▪ Class III on one side and class I on other

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ETIOLOGY
1. HEREDITY
Main etiologic factor
1. ENVIRONMENTAL INFLUENCES
role of habits and mouth breathing
1. FUNCTIONAL
Abnormal tongue position, nasal-respiratory problems, neuromuscular
conditions
1. SKELETAL
Maxillary transverse discrepancy, excess mandibular growth
1. DENTAL
Ectopic eruption of maxillary central incisors, early loss of deciduous molars

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CLINICAL FEATURES
A] Extraoral features :
1. Concave profile
2. Anterior facial divergence
3. Retrusive nasomaxillary area
4. Prominent lower third of
face/chin
5. Steep mandibular plane angle

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B] Intraoral features :
1. Class III molar and canine
relationship
2. Narrow upper arch
3. Decreased or reverse
overjet
4. Crowding in upper arch and
spaced lower arch

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TREATMENT
PROTOCOL
GROWING
PATIENTS
SKELETAL DENTAL
NONGROWING
PATIENTS
DENTAL SKELETAL
Orthopedic /
myofunctional
appliances
Orthognathic
surgery
Orthodontic
treatment as
needed

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Indications :
Mild to moderate skeletal discrepancies
Growing patients
Functional appliance designed to counteract the
muscle forces acting on the maxillary complex.
MYOFUNCTIONAL APPLIANCES

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FRANKEL III REGULATOR (FR III)
According to Franke1, the vestibular shields in the
depths of the sulcus are placed away from the
alveolar buccal plates of the maxilla to stretch the
periosteum and allow for forward development of
the maxilla.
The shields are fitted closely to the alveolar
process of the mandible to hold or redirect growth
posteriorly.

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1. FACE MASK
Used in patients with mild to
moderate Class III with maxillary
retrusion
2 pads connecting soft tissue in
forehead and chin region
ORTHOPAEDIC APPLIANCES

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2. CHIN CUP
Used in skeletal Class III
malocclusion with a relative
normal maxilla and a moderately
protrusive mandible
Two types:
- Occipital pull
- Vertical pull

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ORTHODONTIC CAMOFLAGE
Indications :
Skeletal discrepancies not resolved during mixed
dentition
Malocclusions recurring during adolescence after
treatment in childhood
Mild mandibular prognathism and moderate crowding
Types :
With extractions
Without extractions

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Class III elastics :
From upper molar to lower
anteriors
Corrects molar relation by
moving the molar mesially
Retraction of lower
anteriors

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ORTHOGNATHIC SURGERY
Indications :
Continued disproportionate sagittal and vertical growth
Severe skeletal maxillary retrusion and mandibular
prognathism or both
Non-growing patients
Cleft lip and palate
Facial asymmetries
Treatment…

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Steps involved :
1. Diagnosis
2. Pre-surgical orthodontics (decompensation)
3. Mock surgery
4. Surgery and stabilization
5. Post-surgical orthodontics
Treatment…

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Mandibular prognathism :
1. Mandibular ramus osteotomy
2. Mandibular inferior body
osteotomy
Treatment…

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Maxillary retrusion :
Le Fort I osteotomy with maxillary advancement
Treatment…

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▪THANK YOU