Early Timely Treatment of Class III Malocclusion

The protraction facemask has been widely used in the treatment of Class III malocclusion with maxillary deficiencies. However, the benefit of this early treatment modality is not clear. One of the reasons orthodontists are reluctant to render early orthopedic treatment in Class III patients is the inability to predict mandibular growth. The use of a single cephalometric radiograph to predict excessive mandibular growth has severe limitations. The use of serial cephalometric radiographs taken a few years after facemask treatment, and a Growth Treatment Response Vector (GTRV) analysis to individualize and enhance the accuracy in predicting excessive mandibular growth, is presented and proposed. This article discusses the rationale for early “timely” treatment of Class III malocclusion, the indications and contraindications for early Class III treatment, and provides a method of predicting excessive mandibular growth using the GTRV analysis.