Early class III treatment with hybrid rapid palatal expander combined with facemask

Background: Class III patients are characterized by a deficiency of the maxilla and/or a prognathism of the mandible and require early treatment. Diagnosis > This case report describes the treatment of a 5-year-old patient with a skeletal class III relationship, a significant mandibular symphysis deviation towards the right side and a different height of the mandibular angles. Management and outcome > The patient was treated with rapid maxillary expander combined with miniscrew, facemask and aligners. A functional and aesthetic occlusion in an improved facial profile was established at the end of the orthodontic treatment. Pre-treatment, post-treatment and one year retention records for the patient are presented. Discussion > Class III patients require early treatment in order to optimize the traditional expander effects; subsequently hybrid anchorage allowed to maximize skeletal advancement. In addition, loss of space for the erupting teeth and dento-alveolar tipping were avoided. The good results of the phase I treatment and of the active retainer meant that a complex case would become relatively simple at the phase II treatment.