SMILES
SPOTLIGHT
in the
LEADERS IN NORTH TEXAS DENTISTRY
CREATING UNFORGETTABLE SMILES
Class III Skeletal Malocclusion
16 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
How the patient presented
Adolescent female patient presented with an underbite and front
upper and lower teeth that did not touch. She had an inability to bite
into foods, a condition that had worsened in recent years. Functional
concerns included the habits of mouth breathing and snoring.
Examination showed severe Class III molar relationship (full molar),
anterior open bite, and a reverse overjet of approximately 5-6 mm.
There was moderate maxillary dental crowding and a constricted
maxilla with bilateral posterior cross-bite. The lower teeth were mildly
crowded. The maxillary dental midline was coincident with facial midline, but the mandibular midline deviated to the right. Both maxillary
1st molars had heavy restorations.
Both lingual tonsils were significantly enlarged, with the right tonsil
crossing the midline and displacing the uvula.
Facially, the upper lip was mildly retrusive, and the soft tissue profile
concave with moderate maxillary infraorbital and paranasal hypoplasia; she also displayed mild mandibular asymmetry with chin deviated
to the right side ~ 2mm. Head type was dolichocephalic, and the chinneck length appeared adequate.
Oral hygiene was fair with mild generalized marginal gingivitis and
some generalized extrinsic dental staining – especially lingual of maxillary incisors. Also noted was a lingual periodontal defect associated
with the upper right 2nd bicuspid and an over-retained deciduous 2nd
molar.
Comprehensive diagnostic workup included full orthodontic diagnostic
records, a thorough review of prior patient-supplied photographs from
early c