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KMID : 0354619940060010105
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Journal Dankook Dental Research Institute
1994 Volume.6 No. 1 p.105 ~ p.111
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TREATMENT OF SKELETAL CLASS Ⅲ MALOCCLUSION BY MANDIBULAR PREMODLR EXTRACTION
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Abstract
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True Class Ⅲ malocclusions are difficult to treat because they reflect basal bone discrepancies and there are many limitations to conventional treatment mechanisms. The amount and the timing of growth of the mandible ond maxilla cannot be assessrd accurately, we cannot consider a Class Ⅲ malocclusion flllly resolved until facial growth has ended.
Since many of the conventional treatment procedures have limitations, we should consider the use of orthopedic appliance because appropriate force systems can be placed on the basal bone. Most Class Ⅲ malocclusions can be treated with orthodontic treatment only, but some require orthodontic treatment and surgery. Two valuable measurements to determine which procedure to use are the ANB angle and the Frankfort-mandibular angle (FMA).
For many Class Ⅲ malocclusion, surgical treatment is the best alternative. Depending on the amount of skeletal discrepancy, surgical correction may consist of mandibular shortening, maxillary lengthening, or a combination of mandibular and maxillary procedures. however, there are still associated surgical risks and complications that must be considered, as well as the increased expense. Mandibualr premolar extraction treatment approach is a viable alterative in carefully selected skeletal class Ⅲ cases. This is certainly not a new approach to treatment of a Class Ⅲ case as this type of treatment was commonly used before the advent of orthognathic surgery. Some imfortant factors to consider when estabilishing a Class Ⅲ molar relationship. The one must accept tte potential sacrifice of the upper second and third molars unless the lower third molars erupt into occlusion.
Maxillary first molar occludes with the mandibular second molar so the maxillary second molar occlude with mandibular third molars may erupt into occlusion at a later time. Detailing of the occlusion, especially in the upper second premolar-lower first molar area is very important.
Given the risk of general anesthesia, trauma to the jaws, and possible risk to joint function that is often present in surgical treatment, I believe this treatment approach is a viable alternative in carefully Selected skeletal Class Ⅲ cases.
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