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KMID : 1149720230130030222
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Clinical Journal of Korean association of Orthodontists
2023 Volume.13 No. 3 p.222 ~ p.232
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Increase in Occlusal Vertical Dimension in a Patient with Skeletal Class III Malocclusion and Severe Hypodivergent Pattern: Utilization of Removable Appliance and Botulinum Toxin
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Jeon Eun-Jeong
Jeong Han-Nah
Choi Dong-Soon
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Abstract
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Clockwise rotation of the mandible has been found effective in correcting Class III malocclusion with anteroposterior skeletal discrepancy. However, increasing the occlusal vertical dimension in severe hypodivergent patients poses a significant challenge. This case report describes a camouflage treatment approach in a patient with severe hypodivergent Class III malocclusion. Treatment was done using a removable appliance and application of botulinum toxin A to increase the occlusal vertical dimension. A 25-year-old male patient presented with an anterior crossbite, Class III molar relationship, deep overbite, and prognathic chin. Cephalometric analysis revealed a skeletal Class III relationship (ANB -3.3°) and severe hypodivergence (Go-Me to FH plane angle 6.5°). An upper removable acrylic appliance, consisting of an inverted labial bow, anteroposterior expansion screw, and posterior bite block, was applied to correct the anterior crossbite and reduce the overbite. Fixed orthodontic appliances were subsequently used to extrude the posterior teeth and align the dentition. Bilateral injections of botulinum toxin A were done on the masseter muscle to reduce muscle tone. After 18 months of treatment, normal occlusion and good interdigitation were achieved, and his facial profile was dramatically improved due to mandibular backward rotation.
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KEYWORD
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Class III treatment, Adult patient, Botulinum toxin, Removable orthodontic appliances
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