Treatment of skeletal, hyperdivergent, asymmetrical Class III, using intermaxillary elastics anchored to miniplates, associated with passive self-ligating appliances

Henrique Mascarenhas Villela

Introduction: The use of intermaxillary elastics applied to miniplates has proven efficient in the correction of skeletal Class III malocclusions to perform maxillary protraction. In addition to the orthopedic effect on the maxilla, intermaxillary elastics can achieve excellent results in redirecting mandibular growth, controlling the vertical component, as well as the asymmetry. When this strategy is associated with orthodontic treatment using passive self-ligating appliances with individualized prescription, dental compensation can be inhibited. When this strategy is associated with orthodontic treatment with passive self-ligating appliances with individualized prescription, dental compensation can be inhibited. Objective: This article presents a clinical case report showing an orthopedic and orthodontic treatment strategy for the correction of skeletal, hyperdivergent, asymmetrical Class III. Intermaxillary elastics were used on the miniplates located in the infra-zygomatic ridge and in the anterior region of the mandible. After one year of orthopedic treatment, a passive self-ligating fixed orthodontic appliance was installed, with individualized prescriptions. Result: The orthopedic changes were: 9.5 mm in Wits measurement (from -11.0 mm to -1.5 mm), 3.5o increase in ANB (-4.5o to -1.0o ), 8o reduction in the FMA mandibular plane (31o to 23o ) and correction of mandibular asymmetry. The most significant orthodontic effect was the correction of severe crowding in the maxillary arch by using negative torques on the incisor brackets, providing a buccal bodily movement (1.PP = 117o ). In the mandibular arch, there were no changes in incisor inclinations (IMPA= 89°). Conclusion: This strategy was efficient in skeletal Class III correction, achieving major orthopedic changes in the maxilla and mandible, and inhibiting dental compensations.

Keywords: Class III malocclusion. Miniplate. Maxillary deficiency. Asymmetry. Hyperdivergent. Self-ligating appliances. Variable prescriptions.

How to cite: Villela HM. Treatment of skeletal, hyperdivergent, asymmetrical Class III, using intermaxillary elastics anchored to miniplates, associated with passive self-ligating appliances with individualized prescription. Clin Orthod. 2021 Jun-Jul;20(3):76-97.

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