Stability Of Non-Surgical Treatment For Severe Skeletal Class III Malocclusion

A patient with severe skeletal Class III malocclusion showed improved facial profile and normalized occlusion after Orthodontic protraction and expansion treatment treatment. The treatment outcome remained stable over 5 years of follow-up. A 14-year-old female patient presented with anterior crossbite and protruding chin, severely affecting aesthetics. Pre-treatment examination revealed mesial molar relationship, midface concavity, and lower facial protrusion. Cephalometric analysis showed ANB: -5.94°, Wits: -12.01 mm, overjet: -4.63 mm. Cervical vertebral maturation indicated limited growth potential (CVM stage 5), but CBCT showed unfused zygomaticomaxillary sutures. The patient’s parents refused orthognathic surgery. The patient underwent one year of protraction and expansion treatment to correct the crossbite and midface deficiency, followed by two years of fixed orthodontic treatment to adjust the occlusion. After treatment, the patient wore Hawley and clear overlay retainer retainers for two years. Follow-up at six months, one year, two years, and five years post-treatment showed stable results. Orthognathic surgery was the preferred treatment option for the patient. Despite limited growth potential, the patient’s unfused sutures allowed successful non-surgical orthopedic treatment with stable long-term outcomes. Timely treatment before bony suture fusion allows the optimal interaction between external forces and growth. Cervical vertebral maturation (CVM) should not be the sole indicator of growth potential. The degree of suture fusion is crucial for assessing the feasibility and stability of protraction treatment in skeletal Class III malocclusion.