CORRECTION OF CLASS III MALOCCLUSION USING RAPID MAXILLARY EXPANSION ( RME )

This is the case report of an 8 year old female patient reported to the Department of Orthodontics, whosechief complaint was crooked teeth. The patient desired treatment for esthetic and functional reasons.
Extra oral examination :

• Shape of head - mesocephalic
• Facial profile - orthognathic
• Facial divergence - straight
• Inter labial gap - 3 mm
• Naso labial angle - acute
• Maxilla - retrusive

Intra oral examination :

• Number of teeth
• Rotations
• Crowding of lower anteriors

Maxillary arch : U shaped, average size, symmetrical, with rotations of teeth.
Mandibular arch : U shaped, average size, symmetrical, with crowding of anterior teeth.
Arches in occlusion :

• Antero-posterior relation :

1. Molar relation : right / left - Class I relation
2. Overjet - reversed
3. Anterior cross-bite present

• Transverse relation :

1. Posterior cross-bite present
2. Midline shift to the right by 1 mm

Diagnostic records :

• Study models
• Radiographs :

1. Hand - wrist radiographs
2. Cephalometrics - Cephalometric analysis was done using Steiner's analysis, Mc Nawara's analysis, and Bjork's polygon.
3. Orthopantemograph ( OPG )

Diagnosis & treatment records : From the cephalometric analysis and study models, it was inferred that the patient had Class III jaw bases with Class I molar relation along with anterior and posterior cross-bite ( maxilla contracted ), with lower anterior crowding.
Treatment Objectives :

1. Cross-bite corrections ( anterior and posterior )
2. De-rotation
3. Lower incisor de-crowding

Treatment plan :

1. Rapid maxillary expansion (RME ) with extraoral traction ( bonded type )
2. IInd phase levelling and aligning

The type of appliance used was fixed and the estimated duration of treatment was 3 years, with a 3 year retention period. The prognosis and stability after treatment was good.