Early treatment of Class III malocclusion: is it worth the burden?

at Protraction facemask therapy has been advocated in early treatment of Class III malocclusions with maxillary deficiency. The dental and skeletal effects of this appliance are well documented in the literature. One reason tha clinicians are sometimes reluctant to render early orthopedic treatment in Class III patients is the inability to predict mandibular growth. 6 Patients receiving early orthodontic or orthopedic treatment might need surgical treatment at the end of the growth period. Is it worth the burden to treat a Class III malocclusion early? If so, what type of Class III malocclusions will benefit from early facemask treatment? When is the best time to start treatment? Can early treatment help to predict excessive mandibular growth? The severity of Class III malocclusions ranges from dentoalveolar problems with anterior posturing of the mandible to true skeletal problems with significant maxillomandibular discrepancies. 6 In addition, the con dition could be complicated by vertical growth problems. A systematic way to diagnose Class III malocclusion can help in identifying patients who might respond favorably to early orthopedic treatment (Fig For the dental assessment, check whether the Class III molar relationship is accompanied by a negative overjet. A positive overjet or end-to-end incisal relationship together with retroclined mandibular incisors usually signifies a compensated Class III malocclusion. For the functional assessment, check whether a centric relation (CR) or centric occlusion (CO) discrepancy exists.