What are my treatment options for a Class III Malocclusion?

I’m a 24 year old female. My jaw and side profile have always bothered me growing up, and I hated taking pictures as a result. An X-ray revealed Class 3 malocclusion, with my jaw slanted to the left by about 1cm. I also had a crossbite. I was told that I had only 2 options – the ‘compensation method’ using metal braces which would take about 1.5 – 2 years, or jaw surgery and braces before and after, which would take almost 3 years. What are possible treatment options for a Class III Malocclusion? Can braces alone fix my problem? My main considerations are treatments that are cost-efficient, require a shorter treatment time, and produce good results (I want a nice facial profile and a nice smile).

 


 

Class 3 skeletal malocclusion occurs when:

1) The upper jaw is undersized in relation to the lower

2) The lower jaw is too large in relation to the upper

3) Both the upper jaw is undersized and the lower jaw is too large in relation to each other

A crossbite may also appear in class 3 malocclusion as a result of the jaw size discrepancy, tooth size discrepancy or poor tooth alignment. The crossbite may cause your jaw to bite unevenly, and if this is not corrected early (from the age of 8 onwards), the slant may become permanent in adulthood.

Managing class 3 malocclusions in adults generally boils down to one of 2 options:

1) Camouflage or compensation with braces alone.

This aims to hide or camouflage MILD skeletal discrepancy by realigning the teeth. This can improve minor crossbites but cannot improve jaw shape, size and facial profile.

Camouflage can be successful for cases with acceptable facial profile and is the only non-surgical option.

Realignment of your teeth can be done with braces (this is the most expedient and your dentist has the greatest control of tooth movement, especially if extractions are required) or Invisalign. Braces are definitely the most cost-effective.

2) Orthognathic surgery (jaw surgery) and braces

Orthognathic surgery aims to correct the underlying skeletal discrepancy so that the foundations (your jaw bones) for the teeth are in the right place. This can improve skeletal crossbites as well as the facial profile and jawline.

Whether only one jaw or both jaws should be corrected can be determined from measurements on a lateral cephalogram (a profile view xray of the skull).

Fixed braces are required to set up the bite to guide the surgeon during the surgical repositioning. The braces will also be used to stabilize the jawbones immediately after the surgery and during healing. After the surgery, finishing adjustments will also be required.

Since you are an adult, it is unlikely that you will hit another growth spurt late in life and reverse the effects of the surgery. This sometimes happens if the surgery is done in late adolescence and the lower jaw continues to grow.

Ultimately, jaw surgery and braces will give the most complete solution especially in cases of severe class 3 malocclusion.

Dr. Jaclyn Toh
jaclyn_toh@elitedental.com.sg


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