Revolutionizing orthodontics: Effective management of Class III skeletal malocclusion using innovative buccal shelf bone screws

Abstract

The advent of the temporary anchorage devices has revised the envelope of discrepancy in modern orthodontic practice. Orthodontic camouflage is opted in situations where the patient is reluctant to have an invasive orthognathic surgical procedure and the associated risks or where, by the use of temporary anchorage devices, the orthodontic envelope can be expanded, and optimal orthodontic result can be obtained non surgically. In such cases, TAD’s can be used to obtain an acceptable orthodontic result with a cusp to fossa posterior relation, an optimal aesthetic outcome, and a functional occlusion. This case report showcases a camouflage treatment of a Class III non-growing patient treated by use of TAD’s, to cause clockwise rotation of maxillo- mandibular occlusal complex for achieving optimum molar relation, facial esthetics, and function.A case of skeletal and Angle’s Class III malocclusion is presented where orthodontic camouflage was carried out to deliver optimal orthodontic results. This was achieved effectively by in toto distalization of the lower arch. This was brought about with the use of two extra alveolar TAD’s placed in the buccal shelf region of the lower arch. Two 2 x 12 mm bone screws were used, after space creation by extraction of lower third molars bilaterally, and elastic chains was the chosen force delivery system. Here in toto distalization of the lower arch was achieved to end in an Angle’s class I molar and canine relationship with normal overjet and overbite. Total treatment duration was of 17 months.Challenging skeletal malocclusions can be treated non surgically by effective use of TAD’s and correct and efficient use of biomechanics.