Case Presentation

Class III malocclusion with anterior crossbite

Presenter : Eddie Hsiang-Hua Lai

Date : 2018.03.24

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 General data
2018-03-24

 Name : Miss Lin

 Age : 44 y/o
 Chart number : 10-452
 Gender : female
 Finance : fair
 Motivation : good
 Cooperation : good
 Time factor : fair

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 General data
2018-03-24

 Chief complaint :

 Upper left anterior crowding

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 General data
2018-03-24

• PMH : Aortic valve prolapse

• PDH : OD, scaling
• Functional examination :
• No clicking sound and muscle palpation tenderness
• No TMD history
• MMO = 43.5 mm
• C.O.-C.R. discrepancy
• Family history : father (Class III )

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 Pre-treatment extra-oral photos
2018-03-24

• L’t face > R’t • Upper dental midline : • Midface mild flattened
• No gummy smile coincident with facial • Concave profile
midline • NLA about 90 degrees

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 Pre-treatment intra-oral photos
2018-03-24

• Arch form :
Upper & lower : square
• OJ : -3.5 mm • Anterior crossbite
• OB : 3mm • #22 PFM crown

• Upper and lower dental • Space analysis :

midline : coincident with Upper anterior - 4 mm
facial midline Lower anterior - 2 mm

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 2018-03-24

Canine Molar •Bolton’s analysis :

R’t III III Ant.ratio : 81.3%, U-2.4 mm
Overall ratio : 87.8%, U+3.5 mm
L’t III III

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2018-03-24

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 Pre-treatment
Lateral ceph
Measurement Original Norm
2018-03-24 data
SKELETAL
SNA 85 81.5 ° ± 3.5
SNB 85.5 77.7 ° ± 3.2
ANB -0.5 4.0 ° ± 1.8
NAP -4 5.1 ° ± 3.8
SN-FH 7 5.7 ° ± 3.0
SN-MP 28.5 33.0 ° ± 1.8
UFH/LFH 45.5/54.5 45% / 55%

DENTAL
U1-SN 112 108.2 ° ± 5.4
U1-L1 122.5 119.9 ° ± 8.5
L1-MP 98 93.7 ° ± 6.3
U1-NP 4 6.4 ± 2.7mm

SOFT TISSUE
UL-NPg -2 -1.12.2
LL-NPg 1.5 0.52.5 9
 2018-03-24

 Skeletal
 Class III with low MPA
 Dental
 Class III malocclusion with functional shift
 Anterior crossbite
 Upper mild crowding
 Soft tissue
 Concave profile
 Midface mild flattened

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 2018-03-24

 Non-extraction treatment approach with anterior

teeth flaring
 Upper bilateral posterior TADs for dental Class II
correction in C.R. position
 #22 prosthesis refabrication

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 2018-03-24

 Establish normal overjet and overbite

 Relieve crowding
 Achieve bilateral Class I canine and molar
relationship
 Improve facial esthetics

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 Discussion
Class III malocclusion with anterior crossbite

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Thank you for your attention!

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