Appropriate timing of early orthodontic treatment in Class III malocclusion subjects

The aim of this study was to determine the best timing to modify skeletal growth and to underline the importance of early dento-facial functional orthopedics in the prevention and correction of severe skeletal class III deformities. Were considered two experimental groups with 67 patients aged 4-15 years old, 32 males 35 females, treated with protraction headgear or face mask, palatal expansion, orthopedic and fixed orthodontic appliances. The typical protocol of orthopedic correction produced forward and downward movement of the maxilla with concomitant forward and downward movement of the maxillary dentition, downward and backward rotation of the mandible, and retroclination of the mandibular incisors. These changes were contraindicated in the class III pattern with excessive vertical development. Significant skeletal changes with great improvement in the soft tissue were observed above all in deep bite malocclusion. A significantly better correction of the class III pattern with orthopedic appliances was observed in 4 to 9 years old. Face mask produced important dental and skeletal changes in older children, when the collaboration and the growth were greater. The early treatment during either the primary or transitional dentition could intercept malocclusions with a better and more stable results, reduce the time and the complexity of fixed appliance therapy. Unlike deep bite, open bite cases must have a corrective approach much earlier to resolve vertical discrepancies. .