Buccal Multiloop Appliance: Innovative Therapy On Class ⅲ Malocclusion

Buccal Multiloop Removable Appliance (BMRA) was innovated to treat a 12-year-old girl with both anterior and posterior crossbite, yielding satisfied results. The patient diagnosed with skeletal Class III malocclusion (Cvs 4) attributable to maxillary hypoplasia and an inability to retract the mandible, declined orthognathic surgery. BMRA supplemented by a maxillary expansion screw device started the treatment for 8 months, achieving normal overbite and overjet, followed by fixed orthodontic treatment. After treatment with the removable appliance, the facial profile improved significantly (SNA increased, ANB increased, MP-SN increased from 45.2 degrees to 46.2 degrees). Follow-up 1.5 years, the facial aesthetics and occlusion remained stable. BMRA was invented on 2006. It is characterized by multy loops on the left and right buccal side jointing the upper and lower dentition with splints, which can generate 350-400g of orthopedic force. Additionally, it can be used in conjunction with expansion device and/or protraction device. By seizing the treatment opportunity, this approach corrected crossbite and avoided surgery. In this case, the patient was satisfied wearing the BMRA after the failure of the traditional therapy. The novel BMRA facilitated maxillary advancement and minimal clockwise rotation of the mandible, enabling rapid correction of anterior crossbite and improved facial profile.