Early Comprehensive Sequential Treatment For Angle Class ⅲ Malocclusion

Introduction: Comprehensive sequential management of orthodontic treatment, supernumerary tooth extraction, caries control in a pediatric patient with Angle Class Ⅲ malocclusion. Case description: A 5-year-old male patient presented with anterior crossbite. Panoramic and lateral cephalometric radiographs revealed: 1. Functional anterior crossbite; 2. Supernumerary tooth; 3. Caries treatment. The treatment was divided into two stages: Phase Ⅰ (2022.2ཞ2022.10): Initial treatment with a Frankel-Ⅲ functional orthodontic device was attempted but switched to a lingual spring appliance due to poor patient compliance. Crossbite was resolved after 7 months. Phase Ⅱ (2023.9ཞ2024.10): One year after Phase I revealed persistent crossbite in the erupting permanent incisors. Following comprehensive imaging evaluation, sequential interventions including supernumerary tooth extraction, caries treatment, stainless steel crown restoration, pit and fissure sealing, and fluoride therapy—were performed. A facemask appliance was then used to correct the mixed dentition crossbite, resulting in improved sagittal maxillary development, resolved anterior crossbite, and mitigated skeletal Class Ⅲ malocclusion. Follow-up (2025.2): Four months post-treatment evaluation confirmed stable functional occlusion and effective caries control. Discussion: 1.Patient compliance is critical for successful early crossbite correction. 2.After crossbite correction, regular follow-up examinations are essential. If crossbite recurs during the mixed dentition, treatment should be initiated. 3.Comprehensive sequential treatment is vital for addressing concurrent oral issues to optimize functional and esthetic outcomes. Conclusion/clinical significance: Early comprehensive sequential treatment resolves Class Ⅲ malocclusion, ensuring stable occlusion and caries control.