Facemask Early Treatment Followed by Fixed Appliance for an Angle Class III Malocclusion – A Long Term Follow Up Case Report

Abstract

Aim: The prevalence of Angle Class III malocclusion is about 5- 15% of the Asian population. For Class III early orthodontic treatments, facemask or chin–cap or some removable appliances were often suggested by clinicians. The aim of this report is to discuss the Class III early treatment effect of facemask.  Methods: In this case report, a 10 years old boy with Angle Class III malocclusion was treated with facemask protraction in Phase I then followed by fixed appliance to complete Phase II treatment. Results: The anterior cross-bite was addressed and a good profile improvement was attained after one year of facemask treatment. Owing to moderate crowding in early permanent dentition, Phase II treatment using fixed appliance with four first premolar extraction was completed with Class I occlusion at 14 years old. (Treatment changes—SNA: 78 °to 80°; SNB: 79 °to 78°; ANB: from -1°to 2°; Maxilla CCW rotation, palatal plane & functional occlusal plane flattened). The occlusion was well maintained 13 years after treatment, according to the long-term follow-up results. Conclusion: Angle Class III children require early orthodontic therapy, which orthodontists must provide. The mandibular growth can be steered into a more favourable growth pattern once the anterior cross-bite has been addressed.  And hopefully, the achieved occlusion could be maintained into adulthood.