Correction of skeletal Class III in mixed dentition: A case report

Antônio Giroto dos Santos¹ image, Thaísa Maria Vellasco Queiroz Pimenta2 image, Gabby Chacon Ruiz3 image, Sara Gollino4 image, Franciele Lucca Longo5 image, Gabriela Leite Pedroso6 image, Paôla Caroline da Silva Mira7 image, Maria Bernadete Sasso Stuani8 image

Highlights

Early orthopedic treatment with rapid maxillary expansion and facial mask improved skeletal Class III malocclusion and facial harmony in a growing patient.

Orthopedic intervention corrected maxillary retrusion, achieving positive overjet, Class I molar relationship, and improved cephalometric outcomes.

Early treatment may reduce the severity of Class III malocclusion and minimize the future need for surgical or complex orthodontic interventions.

Abstract

Anterior crossbite rarely resolves spontaneously, and early orthodontic intervention is often necessary to support normal maxillofacial development. The present case involved a patient with anterior crossbite and skeletal Class III malocclusion, characterized by a concave facial profile. In both habitual maximum intercuspation (HMI) and centric relation (CR), the molar and canine relationships were classified as Angle Class III, with a mesial terminal plane in the second primary molars. Initial cephalometric analysis confirmed skeletal Class III malocclusion, with upright and retruded maxillary incisors, and well-positioned mandibular incisors relative to the apical base. The soft tissue profile was concave, while the skeletal profile appeared straight. Orthopedic intervention was initiated during the mixed dentition phase. The treatment plan included rapid maxillary expansion (RME) using the McNamara appliance, followed by maxillary protraction (MP) with a facial mask. Follow-up continued through the completion of craniofacial growth. The chosen approach was effective in correcting the malocclusion during the mixed dentition phase, demonstrating the utility of early orthopedic intervention in managing skeletal Class III discrepancies.

Keywords: Dentition, Interceptive; Malocclusion; Mixed; Orthodontic Appliances

Author Affiliations

  1. Master Student, Departament of Orthodontics, University of São Paulo, Brazil

  2. PhD Student, Departament of Orthodontics, University of São Paulo, Brazil (Correspondence:thaisa.pimenta@usp.br)

  3.  PhD Student, Departament of Orthodontics, University of São Paulo, Brazil

  4.  PhD Student, Departament of Orthodontics, University of São Paulo, Brazil

  5.  PhD Student, Departament of Orthodontics, University of São Paulo, Brazil

  6. PhD Student, Departament of Orthodontics, University of São Paulo, Brazil

  7.  PhD Student, Departament of Orthodontics, University of São Paulo, Brazil

  8.  Assoc. Prof., Departament of Orthodontics, University of São Paulo, Brazil

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Article Info

Contemp Pediatr Dent 2025:6(2):160-171

Received: 24 April 2025

Accepted: 03 July 2025

Online First: 03 August 2025

DOI: 10.51463/cpd.2025.18

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					Antônio Giroto dos Santos, Thaísa Maria Vellasco Queiroz Pimenta, Gabby Chacon Ruiz, Sara Gollino, Franciele Lucca Longo, Gabriela Leite Pedroso, Paôla Caroline da Silva Mira, Maria Bernadete Sasso Stuani. Correction of skeletal Class III in mixed dentition: A case report. Contemp Pediatr Dent 2025:6(2):160-171

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