Maxillary Protraction With Lingual Spur For Skeletal Class Iii Malocclusion

This report details the successful correction of skeletal Class III malocclusion in a 6-year-old girl using a maxillary clasp-type pad-borne protraction appliance with lingual spurs. The patient, a 6-year-old girl, with the chief complaint of seeking treatment for an underbite. She was in the early mixed dentition stage with a 3-mm anterior open bite, 4.5-mm reverse overjet, unattractive profile, and tongue thrusting habit. Her maternal uncle had a similar underbite history. X-ray showed a skeletal Class III pattern with maxillary hypoplasia and CVMS I. To correct the malocclusion and tongue thrusting habit, maxillary protraction combined with lingual spur therapy was used. Normal overjet was achieved after 4 weeks, with noticeable profile improvement. After 12 weeks of active treatment, maxillary length increased, overbite and overjet enhanced. The appliance was then removed, and the FR III appliance was used for retention. Although the protraction device was worn for less than 12 hours per day, the treatment achieved remarkable results. The reasons may include: First, the patient is in the pre-pubertal growth spurt and early mixed dentition stage, with significant growth potential. Second, the appliance combines maxillary pad-borne cemented retention and clasp retention, ensuring stability and providing continuous force for orthopedic treatment. Early intervention during the mixed dentition period can achieve satisfactory results for Class III malocclusion. Addressing bad habits with tools like lingual spurs is essential. Effective appliance retention is crucial for successful treatment.