Class III malocclusions with a severe hyperdivergent growth pattern are very complex to plan and treat. This case report describes the treatment of an adult with a skeletal Class III malocclusion with a midface deficiency, severe bilateral posterior crossbite, and a severe hyperdivergent growth pattern by a combination of a bonded rapid maxillary expansion appliance and surgical procedure of Le Fort I osteotomy for maxillary advancement.

Cross bite and deep bite are very common problems, which we face today. These problems lead to either debonding of the brackets or delay in the treatment. Bite opening has always been a boon to evolve through these situations. This block is easy to fabricate and can be used in an advantage without the delay of the treatment.

Editorial

The management of patients with cleft lip and cleft palate requires prolonged orthodontic and surgical treatment and an interdisciplinary approach in providing them with optimal esthetics, function, and stability. This paper describes an update on the current concepts and principles in the treatment of patients with cleft lip and palate. Sequencing and timing of orthodontic/orthopedic and surgical treatment in infancy, early mixed dentition, early permanent dentition, and after the completion of facial growth will be discussed.

First class appliance produces rapid distalization of the maxillary first and second molars, even when the second molars are completely erupted. The range of molar distalization is 4-8 mm. It has both buccal and palatal component. Here, we are going to present a technique to reactivate a broken first class appliance for effective distalization.

Background Various elements contributing to good functional occlusion have not been clearly assessed with cephalometrics for the diagnosis of functional problems and their application in clinical practice. The aim of this study, therefore, was to analyze different components of functional occlusion to formulate concise functional cephalometric analysis. Materials And Methods Eighty-two cases (38 males and 44 females), with class I occlusion and balanced facial profile, were examined based on the selection criteria, and cephalograms were taken in natural head position. All the radiographs were then analyzed using various functional parameters. Results The mean values of condylar path angle and incisal path angle were 55.83° and 65.67°, respectively, with large deviations. However, both showed positive correlation. The value of the angle of long axis of mandibular incisor with respect to the line joining center of condyle and lower incisor tip was 88.04°. Moreover, the angle between the occlusal plane and horizontal plane was 12.88°. In vertical plane, lower face height (LFH) was found to be slightly less than the upper face height. Maxilla contributed around 45% of the LFH while mandible formed about 60%. Furthermore, upper alveolar component (maxillary alveolar height) formed more than half of the maxilla (53.79%) whereas lower alveolar component (mandibular alveolar height) was 74.8% of the mandible. Conclusion This study has analyzed various components of functional occlusion and formulated a concise functional cephalometric analysis for diagnosis, treatment planning, and assessment of treatment results.

Objective The aim of this study is to describe the evolution of the ANB and SN-GoGn angles throughout development, in a longitudinal sample of Caucasian patients. Materials And Methods Historical cephalometric records from North American individuals available at the American Association of Orthodontists Foundation Craniofacial Legacy Growth Collection website were used to carry out an exploratory longitudinal study. Lateral cephalometric radiographs of orthodontically untreated males and females were included. Individuals with three or more longitudinal cephalometric records at pre- and post-pubertal stages, with at least one postpubertal radiograph available in vertebral cervical maturation stage (cervical vertebral maturation) 5 or 6, were selected. Seventy-one individuals met the inclusion criteria. ANB, SNA, SNB, and SN-GoGn angles were measured. Individuals were classified according to the latest postpubertal ANB angle available and grouped by CVM. Descriptive statistics were obtained for the cephalometric variables, and differences between genders were analyzed. Results Forty-five individuals were classified as skeletal Class I at the end of growth, 17 as Class II, and 9 as Class III. ANB values decrease as growth occurs in every group (average ANB decrease between the stages CVM 1 and 6: Class I - 1.5°, Class II - 0.7°, and Class III - 3.1°). For SN-GoGn angle, a constant reduction was observed as skeletal maturation increased (Average SN-GoGn decrease between the stages CVM 1 and 6: Class I - 4°, Class II - 2.5°, and Class III - 4.9°). Conclusions ANB and SN-GoGn angles decrease during growth. The magnitude varies depending on individual sagittal characteristics, Class III individuals displaying the greatest reduction, and Class II individuals the least.

Introduction Crowding is a malocclusion with irregularly positioned teeth caused by arch length discrepancy (ALD). Its incidence is high compared with the various malocclusions. In a previous study the crowns of the maxillary lateral teeth had erupted mesially in relation to the functional occlusal plane (FOP) in patients with Angle Class I malocclusion and highly erupted canines, which had been uprighted by non-extraction orthodontic treatment, yet these results were based on only two cases evaluated by using plaster models. Therefore, the aim of this study was to assess the mesiodistal angulations of both maxillary and mandibular teeth relative to the FOP in normal occlusion by means of cephalograms and identifying the teeth axial factors contributing to the normal dentitions with the least ALD. Materials And Methods Thirty Japanese young adult patients (6 males, 24 females) with normal occlusion were selected to participate in this study; cephalograms were procured from each and the FOP was used as a reference plane for measuring the changes in the axial angulation along with other indicators of vertical growth. Results Progressive mesial tipping of the maxillary lateral teeth was observed. First premolars tended to express this more than the second premolars but the tipping values were roughly 90º relative to the FOP on the first molars. Conclusion The maxillary lateral teeth are more mesially angulated compared to the mandibular ones relative to the FOP. Furthermore, progressive mesial tipping of the maxillary lateral teeth was detected, of which axial angulations were significantly correlated to each other, in spite the mandibular premolars and molars being angulated in a similar fashion.

Introduction Class III malocclusions are considered one of the most difficult problems to treat. For us, the complexity of these cases is the esthetics of the face and smile because the treatment of these malocclusions without surgery produces a more retrusive face. Diagnosis And Etiology We present a case of an adult male patient with skeletal Class III malocclusion with several crowding and impacted canines, who was treated with extractions of the upper canines and lower premolars. Conclusions The result is acceptable in terms of occlusion function, esthetic of the smile, and facial esthetics.