Pacific Coast Society of Orthodontists Bulletin Summer 2021 - 58

Case Report
Special Section: Class III Maloclussion
How would you treat this malocclusion?
Pretreatment
Case K.R. 13 years, 1 month
A video of this case can be found at www.
pcsortho.org/case-reports/
Diagnosis and Etiology
Extraoral and Intraoral Findings
A Hispanic girl, aged 13 years, 1 month,
presents to the University of Pacific Orthodontic
Clinic with the chief complaint of " My
top and bottom front teeth don't touch. "
The patient is in good general health with
no contributing medical history. She has no
previous orthodontic treatment and denies
any oral habits.
Pretreatment facial photographs reveal the
patient has a straight profile with obtuse
nasolabial angle. From the frontal view, her
face is grossly symmetric with the lower
midline coincident with the face and the upper
midline 0.5 mm to the left of her facial
midline. She appears to have an increased
lower facial third due to an increase in the
lower two-thirds. At rest, she has mentalis
strain. Upon animation, she appears to have
adequate incisor show, with excess buccal
corridors (Figure 1). Intraoral and dental
casts reveal a Class I dental relationship
bilaterally. A 4.2-mm open bite and 2.4 mm
of positive overjet are measured at the left
maxillary and mandibular central incisors.
Based on the occlusogram, only the molars
appear to be in contact. She has severe
crowding on the tapered maxillary arch with
the UL2 in linguoversion and mild crowding
in the anterior dentition on the mandibular
arch (Figures 1 and 2).
Radiographic Findings
A full-volume cone-beam computed tomography
was captured before starting treatment,
and the panoramic and cephalometric
radiographs were extracted for interpretation.
The panoramic radiograph reveals no
caries or gross pathology within the generFigure
1. Initial facial and intraoral photographs (K.R., 13 years, 1 month)
Figure 2. Initial dental models
58
PCSO Bulletin Summer 2021
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Pacific Coast Society of Orthodontists Bulletin Summer 2021

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