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Asymmetric mandibular arch distalization with third-molar extractions for nonsurgical correction of skeletal Class III open bite and mandibular deviation: A case report

Year: 2025

Type: article

Abstract: RATIONALE: This case report aimed to describe a premolar preservation, nonsurgical approach for adult skeletal Class III open bite using third-molar extraction and buccal-shelf miniscrew-anchored mandibular arch distalization. PATIENT CONCERNS: A 27-year-old female presenting with a 2 mm anterior open bite, bilateral Class III molar and canine relationships, mild bimaxillary crowding, and midline deviations underwent extraction of all third molars. DIAGNOSES: Skeletal Class III malocclusion secondary to excessive mandibular growth in a horizontal growth pattern, Class III dental relationships with marked proclination of the maxillary and mandibular incisors, anterior crossbite and open bite, and leftward mandibular deviation. INTERVENTIONS: Fixed appliances were bonded to initiate leveling and alignment. Two buccal-shelf miniscrews provided anchorage for en-masse mandibular distalization with power chains and Class III elastics. Interproximal enamel reduction refined the incisal morphology of both the maxillary and mandibular incisors. OUTCOMES: After 19 months of active treatment, all objectives were achieved. Bilateral Class I canine and molar relationships were established, overjet normalized from -1.4 mm to +2.8 mm, and overbite from -1.8 mm to +0.9 mm. The upper lip remained essentially stable, whereas roughly 2 mm of lower-lip retrusion permitted the upper lip to overlap the lower. Both arches were well leveled and aligned, with coincident dental and facial midlines. LESSONS: Selective third-molar extraction combined with buccal-shelf miniscrew-anchored mandibular distalization is an effective nonsurgical alternative for adult skeletal Class III open-bite cases, preserving healthy premolars and delivering stable occlusal and esthetic outcomes.

Source: Medicine

DOI: 10.1097/md.0000000000045919

Authors: Viet Anh Nguyen, Thi Minh Anh Ha, Hong Le Doan

Institution: Phenikaa University

Language: English

Topic: Orthodontics and Dentofacial Orthopedics

Subfield: Orthodontics

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,950