Expert consensus on early orthodontic treatment of class III malocclusion

Abstract

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.

Fig. 1

Schematic diagram of classification of class III malocclusion by pathogenic mechanism. a Dental type. b Skeletal type. c Functional type (The typical feature of functional Class III malocclusion is that the mandible can be retracted to the anterior teeth edge-to-edge position)

Fig. 2

Schematic diagram of classification of class III malocclusion vertical types. a average angle type. b high angle type. c low angle type

Fig. 3

Schematic diagram of removable appliance incorporating z-spring and posterior bite plate

Fig. 4

Schematic diagram of lower inclined bite plane

Fig. 5

Schematic diagram of Fränkel III appliance

Fig. 6

Schematic diagram of tooth-borne reverse-pull headgear

Fig. 7

Schematic diagram of bone-borne reverse-pull headgear

Fig. 8

Schematic diagram of Maxillary protraction with intermaxillary elastics to miniplates

Fig. 9

Schematic diagram of “2 × 4” orthodontic appliance

Fig. 10

Schematic diagram of conventional straight-wire appliance

Fig. 11

Schematic diagram of transmission straight-wire appliance

Fig. 12

Schematic diagram of clear aligners

Fig. 13

Schematic diagram of lingual orthodontic appliance