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Importance of Orthodontic Treatment in Prosthetic Rehabilitation of Class III Malocclusion
Purpose: Class-III malocclusions are classified in three category: functional (pseudo), dentoalveolar and skeletal. Class-III malocclusion may result from mandibular prognathism alone or maxillary hypoplasia and retrognathism, or combination of the two. Decreased occlusal vertical dimension in the frontal and profile extra-oral examination and cross bite relationship are observed during intra oral examination. Generally, in order to meet the aesthetic and functional needs of patients with Class-III malocclusion, prosthetic treatment is needed in addition to orthodontic treatment. Pseudo Class-III patients usually can move their lower jaw posteriorly with guidance. In this position, occlusal vertical dimension usually becomes normal and bilateral posterior open bite can be observed which means prosthodontic rehabilitation may be indicated. In cases where increased occlusal vertical dimension obtained in this position or the anterior teeth are excessively inclined, orthodontic treatment may be recommended before prosthetic treatment. For this purpose, a multidisciplinary approach should be preferred for the rehabilitation of Class-III patients.
Materials and Methods: In this presentation, rehabilitation of pseudo and skeletal Class-III malocclusion cases with esthetic and functional complains were described. Orthodontic treatment was applied for the patients before prosthetic rehabilitation, and prosthodontic treatment is completed as minimally invasive as possible. In the first patient, posterior metal-ceramic restorations and anterior lithium disilicate laminate veneer restorations were applied after the mandibular anterior teeth were intruded with orthodontic treatment. In the second patient, posterior lithium disilicate veneerlay (overlay-vener) restorations and anterior lithium disilicate laminate veneer restorations were applied after orthodontic treatment of maxillary teeth.
Results: The patients were followed up regularly up to 2 years and no complications were encountered. The temporomandibular joints and muscles did not show any dysfunction during the follow-up period.
Conclusion: Before the prosthetic rehabilitation of functional and skeletal Class-III patients, the orthodontic treatment approach increases the success of the treatment.