Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 May 18;18(10):5381.
doi: 10.3390/ijerph18105381.

Skeletal Class III Malocclusion with Lateral Open Bite and Facial Asymmetry Treated with Asymmetric Lower Molar Extraction and Lingual Appliance: A Case Report

Vo Truong Nhu Ngoc  1 , Nguyen Thi Thu Phuong  1 , Nguyen Viet Anh  2
Affiliations
Case Reports

Skeletal Class III Malocclusion with Lateral Open Bite and Facial Asymmetry Treated with Asymmetric Lower Molar Extraction and Lingual Appliance: A Case Report

Vo Truong Nhu Ngoc et al. Int J Environ Res Public Health. .

Abstract

A skeletal Class III malocclusion with open bite tendency is considered very difficult to treat orthodontically without surgery. This case report describes the lingual orthodontic treatment of an adult skeletal Class III patient with mandibular deviation to the left side, lateral open bite, unilateral posterior crossbite, zero overbite and negative overjet. The lower incisors were already retroclined to compensate with the skeletal discrepancy. The patient was treated by asymmetric molar extraction in the mandibular arch to retract the lower incisors and correct the dental midline, with the help of intermaxillary elastics. Lingual appliance was used with over-torqued lower anterior teeth's brackets to control the torque of mandibular incisors. After a 30-month treatment, satisfactory smile and facial esthetics and good occlusion was achieved. A 12-month follow-up confirmed that the outcome was stable. Asymmetric molar extraction could be a viable option to retract mandibular incisors in Class III malocclusion with lower dental midline deviation.

Keywords: lateral open bite; lingual orthodontics; mandibular lateral deviation; molar extraction; skeletal class III malocclusion.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pretreatment photographs.
Figure 2
Figure 2
Pretreatment models.
Figure 3
Figure 3
Pretreatment radiographs and tracing.
Figure 4
Figure 4
Space closure with labial and lingual elastic chains in the lower arch.
Figure 5
Figure 5
15-month treatment follow-up photographs.
Figure 6
Figure 6
Applying intermaxillary elastics to correct transverse and sagittal discrepancies.
Figure 7
Figure 7
26-month treatment follow-up photographs.
Figure 8
Figure 8
Posttreatment photographs.
Figure 9
Figure 9
Posttreatment models.
Figure 10
Figure 10
Post treatment radiographs and tracing.
Figure 11
Figure 11
Overall and regional cephalometric superimpositions: blue, pretreatment; red, posttreatment.
Figure 12
Figure 12
One-year retention photographs.
See this image and copyright information in PMC

References

    1. Antelo O.M., Meira T.M., Oliveira D.D., Pithon M.M., Tanaka O.M. Long-term stability of a Class III malocclusion with severe anterior open bite and bilateral posterior crossbite in a hyperdivergent patient. Am. J. Orthod. Dentofac. Orthop. 2020;157:408–421. doi: 10.1016/j.ajodo.2018.10.029. - DOI - PubMed
    1. Ellis E., 3rd, McNamara J.A., Jr. Components of adult Class III malocclusion. J. Oral. Maxillofac. Surg. 1984;42:295–305. doi: 10.1016/0278-2391(84)90109-5. - DOI - PubMed
    1. Sarver D.M., Weissman S.M. Nonsurgical treatment of open bite in nongrowing patients. Am. J. Orthod. Dentofac. Orthop. 1995;108:651–659. doi: 10.1016/S0889-5406(95)70011-0. - DOI - PubMed
    1. Huang G.J. Long-term stability of anterior open-bitetherapy: A review. Semin. Orthod. 2002;8:162–172. doi: 10.1053/sodo.2002.125436. - DOI
    1. Toffol L.D., Pavoni C., Baccetti T., Franchi L., Cozza P. Orthopedic treatment outcomes in Class III malocclusion. A systematic review: A systematic review. Angle Orthod. 2008;78:561–573. doi: 10.2319/030207-108.1. - DOI - PubMed

Publication types

LinkOut - more resources