Expansion/Facemask Treatment of an Adult Class III Malocclusion

The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask. 1. Introduction The orthodontic treatment of Class III malocclusion with a maxillary deficiency is often treated with maxillary protraction either with or without maxillary expansion [1–4]. Studies on both humans and experimental animals have demonstrated the orthopedic advancement of the maxilla. These studies have shown that a significant component of skeletal class III malocclusion includes maxillary retrusion in combination with a normal or mildly prognathic mandible [5–17]. Skeletal and dental changes have been documented in these studies which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Is there an ideal time to treat a developing class III malocclusion? Just a few studies have examined the effect of age on maxillary protraction therapy. Takada et al. [9] examined 61 Japanese female patients with class III malocclusion, divided into three groups (7 to 10 years, 10 to 12 years, and 12 to 15 years). They concluded that a greater orthopedic effect was observed when therapy was applied before or during the pubertal growth spurt (7 to 12 years). Baik [14] studied maxillary expansion and protraction in 47 Korean subjects, divided into three groups (<10 years, 10 to 12 years, and 12 years or older). He concluded that age did not show any statistically significant difference in treatment effects of expansion/facemask therapy. Braun [18] studied 63 subjects aged 4–13 and found that expansion/facemask therapy produces dentofacial changes that combine to