Long-Term Class III Management With The Growth Modification Method

By Anna Kalmanovich, DMD, Pediatric Dentist, AOS Diplomate

Do we really need orthognathic surgery for severe Class III malocclusion corrections? Many young patients with Class III abnormalities are told not to go through any treatment and wait for growth completion to undergo surgery and orthodontic treatment. However, with early treatment and growth modification, surgery can be avoided, leading to natural and healthy development.

In orthodontics, we have three primary treatment options: growth modification (primary, early mixed dentition), camouflage (adolescent dentition, permanent dentition), and orthognathic surgery (post-growth). Each approach has its place, but the most developmentally harmonious and lasting results occur through growth modification, which takes advantage of a child’s cranial and facial development.

For children who begin orthodontic treatment with permanent dentition, the opportunity for growth modification disappears, and the only treatment option is through camouflage, which involves aligning the teeth to mask skeletal imbalances. If the malocclusion is left untreated for too long and the skeletal discrepancies become too severe, the only remaining solution may be orthognathic surgery. Early treatment is most favorable because it can correct discrepancies that can severely impact lifelong health and increase tongue space, which eliminates the risks associated with sleep apnea and other disorders.

Clinical Analysis

This case study explores the treatment of a young patient with a severe Class III malocclusion and a family history of the same Class III diagnosis corrected with surgical intervention. The child’s parents sought an alternative approach to correcting her condition, one that would avoid surgery all together.