Class 3 malocclusion: How to correct with orthodontics?
Among the different types of malocclusions that exist, class III is one of the most complex.
Also called prognathism, it is an incorrect mandibular development that affects the bite and aesthetics of the person.
As with Class II and other malocclusions, it can be corrected through interceptive orthodontic treatment while the child is still growing.
The most effective solution for this problem varies depending on the age of the person and the severity of each case.
In this article, we tell you why Class III occurs, what types exist and how to correct it.
What is a class III malocclusion?
Class III is an anteroposterior plane malocclusion.
They are characterized by a more advanced position of the lower arch with respect to the upper arch.
According to various epidemiological studies, prognathism is the least frequent type of malocclusion, with figures of less than 5% of the population according to origin and race.
In this type of bite, the lower tusk is at least 3 millimeters in front of the upper tusk.
The lower jaw is outward.
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CLASS III MALOCCLUSION
We say that an occlusion is correct (class I) when it is the opposite, that is, when the upper canine is behind the lower one.
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Types of class III
Class III is divided into two types, depending on whether the problem of occlusion originates in the position of the maxillary bones or in the proportions.
Dentary Class III
In this case, the lower arch is more advanced -or protruded- with respect to the upper arch.
Also known as Angle’s class III, people with this malocclusion have an incorrect relationship between the bones of the mandible and maxilla.
Skeletal Class III
Skeletal malocclusion is characterized by the maxilla being too small, the mandible being too large, or both.
Above all, it is a bone problem that inevitably conditions the patient’s bite.
Causes of mandibular prognathism
There are different etiological factors that lead to the development of class III malocclusion.
Some of them are difficult to avoid, but there are certain habits that we can try to eradicate in order not to develop prognathism.
We explain the causes that can lead to this type of malocclusion:
Genetic inheritance
As with other pathologies, such as periodontal diseases, genetic inheritance has a great influence.
Specifically, this factor has a greater incidence in class 3 malocclusion than in any other.
There are certain symptoms that warn us that our child has prognathism and if we detect them we will be able to find a solution as soon as possible.
Dental malpositions
Permanent upper incisors that grow in a backward position or lower incisors that grow in a forward position can lead to crossbite.
This malocclusion is characterized by an inadequate fit of the teeth.
Specifically, the teeth of the upper arch are behind the lower teeth, either on both sides or only on one -which would generate asymmetries in the face-.
The persistence of this cross-crossing, which is the opposite of normal, can in turn have repercussions on the incorrect development of the bones.
Prognathism in adults
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MANDIBULAR PROGNATHISM
Tongue position
A low and flattened tongue position can also stimulate lower jaw prognathism.
If we notice this symptom, our child should visit a speech therapist who will teach him/her how to hold the tongue.
Abnormal eruption of the teeth
The occlusal forces caused by abnormal eruption of the teeth favor the development of prognathism.
Similarly, premature loss of baby teeth, especially molars, can cause displacement of the jaw.
Thus, in case the lower jaw loses its functional support, it will have a propensity to move forward in order to have contact with other teeth during chewing.
This movement not only causes class III, but will also affect the permanent teeth when they begin to erupt.
Orthodontic Treatment to Correct Class 3 Malocclusion
The first step in order to be able to correctly treat Class III is to perform a thorough study.
This is the only way for the dentist to obtain the information required to know if the mandibular prognathism is dental or skeletal.
Next, we are going to explain how to solve this problem according to its origin and depending on the age of the person.
It is preferable to correct class III during the age of growth. This way, you will avoid having to undergo a more complete surgery in adulthood.
During the growth stage
We have previously mentioned that the treatment indicated to correct Class 3 malocclusion – and any other malocclusion – if the patient is a child, is interceptive orthodontics.
This technique can only be applied up to the age of 11 years, approximately.
Skeletal origin
The child must wear extraoral appliances that stimulate the growth of the maxilla and slow down mandibular development.
There are two types of removable orthodontics which are used very early, between 5 and 6 years of age.
We are talking about the facial mask and the chin guard, although the latter is no longer used too often.
The mask is used in conjunction with a palate disjunctor, which corrects the crossbite, and the child should wear it during sleeping hours.
Dental origin
In this case, the patient should use a Progenie plate that unblocks the anomalous dental relationship but without acting on the bones.
Interceptive orthodontics
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PROGENY PLATE
This appliance consists of a kind of palate made of acrylic material and a metal part so that it is attached to the teeth.
Prognathism in adults
Skeletal origin
In these cases, the only solution is to resort to orthognathic surgery combined with orthodontic treatment.
This operation modifies the size and position of the bones to obtain a functional occlusion.
In addition, the person recovers harmony in the face.
This intervention must be accompanied by dental appliances so that the teeth are aligned and in the right position.
Dental origin
Through braces or any other type of orthodontics, it is possible to move the lower teeth forward and the upper teeth backward.
For these cases, it is common for the orthodontist to use specific intermaxillary elastics to correct class III.
If you need more information about our orthodontic treatments, do not hesitate to contact our dental clinic.
Drs. Daniel Hernandez, Ximena Avila and Andrea Becerril will evaluate your case and advise you on the most effective solution for you.
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- About the Author
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The distinguished Dr. Alberto Wintergerst Fisch is an specialist in Maxillofacial Surgery and has more than 15 years of experience in various prestigious institutions such as DrAW Clinic and Dental Glaf.
He trained as a Dental Surgeon at the National Autonomous University of Mexico, later he completed a specialty in Oral and Maxillofacial Surgery at the same institution and a Master’s Degree in Health Organization Administration at La Salle University.
He is attached to the National Medical Center “20 de Noviembre” of the ISSSTE and certified by the Mexican Board of Oral and Maxillofacial Surgery.
Thanks to this, Dr. Wintergerst Fisch is recognized as one of the best specialists in Oral and Maxillofacial Surgery in Mexico City and the country.
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