Treatment of the Class III Malocclusion with Maxillary Expansion and Protraction

Although some early orthodontic procedures have come under scrutiny in recent years, the need for early identification and treatment of the skeletal Class III malocclusion has become even more universally accepted. Most Class III patients display a retruded maxilla with a normal to deep overbite and are ideally suited for treatment with maxillary expansion and protraction. In addition to maxillary advancement, facemask therapy rotates the maxilla in a counterclockwise direction, and the mandible in a clockwise direction, which results in an increase in lower face height and a profile that is more convex. Early intervention is associated with better patient compliance and possibly a better orthopedic response; however, treatment in the mixed or permanent dentition can produce favorable results. Overcorrection is recommended because treated patients grow similarly to untreated Class III patients after treatment. Treatment in the short term (2-3 years) shows good stability with a minority of patients requiring later facemask therapy.