Skeletal Class Iii Malocclusion With Impacted Teeth: A Case Report

This study reported one child with skeletal Class III malocclusion and impacted anterior teeth successfully treated by interceptive orthodontics. The patient, a 10-year-old girl, came with a chief complaint of “unerupted anterior teeth for 5 months”. Her profile was concave. It was in the mixed dentition. 51, 52, 11 and 12 were not seen and the space for 11 and 12 was insufficient. Molar relationships were Class III. Anterior crossbite was obvious and the mandible could not be retracted to the point of incision to incision. Panoramic radiograph and CBCT showed that 11 and 12 were impacted. Cephalometric radiograph indicated a skeletal Class III relationship (ANB 0.26°), average growth pattern and forward movement of maxillary first molars. The patient was diagnosed with anterior impacted teeth with a skeletal Class III relationship. She was prescribed to a modified Pendulum appliance to move the maxillary first molars distally and protract the maxilla. After molar distalization, surgical exposure of 11 and 12, and 2X4 technique was applied to move 11 and 12 into the maxillary dentition. During the subsequent treatment progress, the patient was instructed to wear FR-III functional appliance 12 h a day. After the interceptive orthodontic treatment, the impacted teeth and anterior crossbite were corrected. The frontal and profile views, and the skeletal Class III relationship were improved (ANB 2.75°). The clinical treatment of the skeletal Class III malocclusion, combined with anterior impacted teeth, requires comprehensive orthodontic evaluation. Prompt interceptive orthodontics are beneficial for this patient.