Interceptive treatment of class III malocclusions – a case report

Class III malocclusions can be divided into two categories: true class III malocclusions and pseudo class III malocclusions. A pseudo class III malocclusion should be treated early in order to eliminate a mandibular shift from the first contact to the maximal intercuspation.

Aim
The aim of this article is to present early treatment of a class III malocclusion in a 10-year-old male patient, using an elastic functional appliance.

Material and methods
The patient was treated with an inverse Stockfisch appliance.

Case report
Early treatment was planned in this patient due to the following reasons: horizontal mandibular growth, a discrepancy between CR and CO, a positive functional test and a non-compensating incisor position. The treatment aimed to accomplish a positive overjet to facilitate further maxillary growth, and to modify the mandibular growth direction from horizontal to vertical. Corrections of an overjet and an overbite were achieved 3 months later. The intercuspation of buccal segments was completed after 8 months. The treatment resulted in an improved facial profile with a symmetrical chin, an elongation of the lower facial height, a positive overjet, Angle class I on the right and cuspid Angle class II (pseudo) on the left.

Summary
An inverse Stockfisch appliance is an effective method of interceptive treatment of pseudo class III malocclusions in cooperating patients. The treatment eliminates a functional mandibular shift, changes the inclination of upper and lower incisors, and changes the growth direction. The stability of treatment outcomes is unpredictable and depends on a further growth pattern of the mandible.