Extreme dentoalveolar compensation in complex skeletal Class III malocclusion with anterior open bite and total crossbite

Abstract

This case report describes the treatment of an adult patient with skeletal Class III malocclusion, total crossbite, and anterior open bite using several biomechanical strategies. The mini-implant-assisted rapid palatal expansion was performed to correct the posterior crossbite. A Carriere Motion Class III distalizer (Henry Schein Orthodontics, Carlsbad, Calif) was installed in the mandibular arch for 8 months in conjunction with maxillary self-ligating appliances. Subsequently, fixed appliances were installed in the mandibular arch, and a mini-implant was placed on the buccal side between the mandibular first and second right molars to distalize the posterior teeth. Lingual spurs bonded to the mandibular incisors, combined with vertical elastics, facilitated the closure of the anterior open bite. After 34 months, satisfactory occlusal, functional, and esthetic results were achieved, highlighting the extreme limitations of compensatory orthodontic treatment of Class III malocclusion.