Early treatment of Class III malocclusion with “skeletal anchorage” using hybrid Hyrax, miniplate and Manhães Bar

Fernando Rayes Manhães

Class III skeletal malocclusion can be corrected in growing patients. In cases of retracted maxilla associated to little or no mandibular protrusion, maxillary protraction either preceded by palatine disjunction or not, is the procedure most frequently used by orthodontists. Maxillary retraction results in anterior-inferior repositioning of the maxilla with clockwise rotation of the mandible, however, it promotes dental compensations. Thus, to present good results, its use is limited to very young children only. The aim of the present article was to demonstrate — by means of clinical case reports — the treatment of skeletal Class II malocclusion using bone anchorage, potentiating the results of protraction, and avoiding or diminishing the undesirable dental effects. This protocol was used in patients before the pubertal growth spurt, and treatment included rapid maxillary expansion associated to support on the molars and two mini-implants (hybrid Hyrax) associated to Class III elastics used 24 hours/day, connected to a miniplate in the chin region, or to a device supported on two mini-implants (Manhães Bar), in addition to a nocturnal facemask. The authors observed considerable maxillary advancement, improved cooperation, absence of dental compensations and effective cost-benefit to the patient.

Keywords: Malocclusion, Angle Class III. Orthodontic anchorage procedures. Palatal expansion technique.

How to cite: Manhães FR. Tratamento precoce da má oclusão de Classe III com “ancoragem esquelética” — Hyrax híbrido, miniplaca e Barra Manhães. Rev Clín Ortod Dental Press. 2017 Out-Nov;16(5):78-95. DOI: https://doi.org/10.14436/1676-6849.16.5.078-095.art

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