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Orthopedic Management of a Class III Malocclusion With Deep Anterior Crossbite and Transverse Discrepancy: A Case
César Sebastián Arcos-López1, Marco González1, Byron Villarreal-Ortega1,2
1Postgraduate Programme in Orthodontics, Faculty of Health Sciences Postgraduate Studies, Universidad UTE, Quito, Ecuador.
Abstract:
Class III malocclusion is a dentoskeletal condition characterized by altered relationships between bones, teeth, and muscular structures. Sagittal and transversal maxillary deficiency is one of the most common patterns, negatively affecting facial esthetics and the psychosocial well-being of the patient. This case report describes an 11-year-old male patient with Class III skeletal malocclusion, a deep anterior crossbite, and a transverse discrepancy. Orthodontic treatment was performed with a mini-implant assisted rapid palatal expansion (MARPE 2S), anchored in the maxilla with two mini-implants, combined with four additional components: two for a face mask and two for the Ertty Gap III protocol, as well as a lip bumper with flanges for 5/16 heavy intermaxillary elastics in Class III mechanics for 24 h a day, attached to a soldered lingual arch. The combination of these orthopedic devices synergistically improved expansion and anteroposterior changes, resulting in significant functional, esthetic, and psychological improvements for the patient.

