Limitations in Orthopedic and Camouflage Treatment for Class III Malocclusion

Skeletal Class III patients can be treated by either orthopedics, orthodontic camouflage, or orthognathic surgery, depending on the degree of skeletal discrepancy, the skeletal pattern, and the age of the patient. The orthopedic approach for growth modification is usually limited to children with growth remaining. Treatment by maxillary protraction is effective in Class III patients with an underdeveloped maxilla and a fairly normal mandible. However, this approach may not be suitable for patients with an overdeveloped mandible or a mandible that continues to grow excessively. Camouflage orthodontic treatment may be performed in patients with a mild skeletal Class III discrepancy and no remaining growth by extracting lower premolars, second molars, incisors, or even using mini-implants. However, in patients with a severe skeletal discrepancy or continuous mandibular growth, it is necessary to consider a combined surgical/orthodontic approach.