Non-surgical Treatment of Severe Skeletal Class III Malocclusion in an Adolescent Patient: A Case Report

Class III malocclusion is one of the most challenging malocclusions in orthodontics. Its nature and multifactorial etiology should be taken into consideration, especially in growing and adolescent patients. Many treatment modalities have been proposed. The wide variety of underlying skeletal and dental components of this malocclusion justifies the different treatment options in the literature. The patient's decision, guided by the orthodontists and maxillofacial surgeons, is fundamental for choosing the appropriate treatment approach for this condition. A major component of this malocclusion is the maxillary transverse deficiency, which necessitates maxillary expansion. Rapid maxillary expansion (RME) has multiple advantages when incorporated into the treatment plan. RME is a type of maxillary expansion that separates the midpalatal suture using different appliances. This case report presents a borderline class III case where a non-surgical approach was adopted to treat an adolescent patient. The non-surgical approach was adopted based on the patient's skeletal age, in addition to the patient's desire and decision. RME was involved followed by a fixed orthodontics appliance with class III elastics. The duration of treatment was 15 months. Forward maxillary movement was observed post-RME. An impacted upper second premolar erupted spontaneously after space gaining, anterior crossbite was corrected, and the ANB angle improved from -2.2 degrees to 1.3 degrees. Esthetically pleasant and functional occlusion was achieved.