Treatment of the noncompliant Class III growing patient

The treatment of skeletal Class III malocclusion is one of the most challenging problems that confronts the practicing orthodontist, particularly in the late deciduous or early mixed dentition periods. In addition to its inherent difficulty, compromised results can also be due to poor patient cooperation; orthopaedic appliances for Class III treatment can be uncomfortable and unaesthetic. There are few acceptable alternatives when a patient refuses to wear an orthopaedic appliance. The aim of this report is to introduce an approach for the treatment of the non compliant dental and skeletal Class III in growing patients. The Smart Wire (SW) is a new orthodontic device simply formed by a 1 mm diameter stainless-steel arch wire that is inserted into the extraoral tube of the upper molar bands. The SW interferes with lower incisors in the front upon mandibular closure. Thus, a distally directed force is applied on the lower incisors and on the mandible while at the same time a mesial force is transmitted onto the upper molars. This combination of force and reaction guides the orthodontic-orthopaedic correction of Class III malocclusions in growing patients.