Table 2 Fig. 2a Patient C.P. Age 3: Early Orthodontic Only, Pre Anterior/Posterior cross-bite “Wits” Appraisal Acceptable Class III Wits -4mm to -6mm. Fig. 3a nal grandfather have a skeletal and dental Class III. Both parents of the triplets are physicians and requested all possible treatment to correct their children’s bite to “normalcy” with-out surgery. (Fig. 1) Fig. 2b Objective The treatment plans of the presented familial early Class III children was to attempt to correct or minimize the developing Class III through growth and development or to have the children in a range of treatment that allows for camouflag-ing the Class III skeletal pattern orthodontically by adulthood. The “Wits” measurement is a reli-able Class III diagnostic aid. (Table 2) The treatment goal being in the range of -4 to -6 mm Wits. by the end of pubertal growth. In female patients, the onset of menstruation is a useful marker for definitive evaluation of the stages of cranio-facial growth, 2,3 with the male lagging behind by a 4-to 5-year period. The cervical verte-bral maturation on a cephalometric film taken annually during the course of treatment also defines remaining or lack of growth potential as it relates to Class III correction. 4 Patient E.P., Age 7: Early Mixed Dentition Anterior Open-bite Tongue Thrust Class III U.A.W. and N.P.E. Treatment. Patient C.P. Age 3: Post treatment “E”-Arch correction Fig. 3b performed for all three children during the transitional stages of the dentition with efficient and effec-tive delivery systems. 5 Phase 1 – Primary Dentition Protocols (Figs. 2a & 2b) í Correction of anterior and posterior cross-bites (“E”-Arches) í Modification of the growth pattern with RPE-RPFM Mechanical Phases & Goals of Treatment Full Conventional Orthodontic Records for each Phase of treat-ment with a defined Treatment and Economic Plan The clinician’s empirical Class III treatment protocol and strategies Phase 2 – Early Mixed Dentition Protocols (Figs. 3a & 3b) í Correct if necessary return of anterior and posterior cross-bite Patient J.P., Age 8, Early Mixed Dentition R.P.E. followed by R.P.F.M. www.orthodontics.com Summer 2019 19
Journal of the American Orthodontic Society Summer 2019: Page 19
