Year: 2025
Type: article
Study design: Case Report
Abstract: De Clerck et al. 11 used intraoral class III elastics, instead of the extraoral facemask, attached to infrazygomatic miniplates in the maxilla and symphyseal miniplates in the mandible.Wilmes et al. [12][13][14] used class III elastics attached to a hybrid hyrax in the maxilla and to mentoplates in the mandible.Recently, several studies have presented a modified protraction technique by inserting miniscrews instead of the anchor plates, known as miniscrew-anchored maxillary protraction (MAMP).[15][16][17][18][19] The use of miniscrews, as temporary anchorage devices, can increase the age limit because the forces are applied directly to the bone.In this article, two cases with class III malocclusions treated with the MAMP technique using miniscrews on both jaws in early adolescent patients are described. Case 1A 12-year-old male patient presented with the chief complaint of an unesthetic smile.He had a class III malocclusion, presented a concave profile, maxillary retrusion, and mandibular protrusion. IntroduCtIonOne of the greatest challenges to orthodontists are class III malocclusions, because many environmental and genetic etiological factors are associated with them. 1 In the European population, the incidence is low, at about 5%.However, in other countries, in the Middle East or Asia, this incidence is higher, ranging from 10 to 15%, respectively.2The growth in class III patients is more unfavorable compared to patients with normal occlusion.In patients with class III, the peak of mandibular growth lasts longer (on average 5-6 months more) than in patients with normal occlusion.3 The maxilla in these patients is smaller than in class I malocclusion.This difference is stabilized early and is preserved up until the age of 16.The mandible is bigger and more protruding, with excess growth that accumulates over the years.Patients usually are hyperdivergent, with increasing inferior facial height.The maxillo-mandibular ratio deteriorates progressively with growth.4 Currently, many treatment options are used in everyday practice.During childhood, interceptive treatment is performed.In permanent dentition, fixed appliances or clear aligners are applied, eventually associated with temporary anchorage devices and/or extractions.In adulthood, surgery first or standard surgical intervention is often selected.[5][6][7][8] Maxillary retrusion is present in about 67% of patients with class III malocclusion.9 After 8-9 years of age, conventional treatment with a facemask has little skeletal effect.The indirect anchorage of the facemask to the upper dentition has many disadvantages, including mesialization of the maxillary dentition, incisor proclination, and lower incisor retroinclination.This facemask treatment increases lower facial height due to mandibular posterior rotation.It has also been demonstrated that sagittal maxillary changes tend to be insignificant at 3-year follow-up.10
Authors: Sidrit Beqiraj, Giovanni M Gravina
Institution: Albanian University
Language: English
Subfield: Orthodontics
Field: Dentistry
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414035033