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Bds4 Ortho > Class 3 > Flashcards

Class 3 Flashcards

1
Q

What is the BSI definition for class 3 incisor relationship?

A

Lower incisor edge occludes anterior to the cingulum plateau of the upper central incisor
The overjet is reduced or reversed

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2
Q

What are some environmental factors for class 3

A

Cleft lip and palate
Acromegaly

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3
Q

What are the 3 aetiological factors of class 3

A

Skeletal
Dental
Soft tissue

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4
Q

In which 3 views is the skeletal component viewed?

A

Antero posterior
Vertical
Transverse

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5
Q

What is the skeletal aetiology of class 3

A

Could be due to small maxilla
Large mandible - most common
Combination of both

Usually presents with class 3 base (the greater the AP discrepancy, the more difficult to treat)

Can be associated with average/ increased por reduced vertical proportions (FMPA and LAFH)

May present with bilateral cross bite if retrusive maxilla sits on wider part of mandible

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6
Q

What are the dental features of class 3

A

These vary
Often class 3 molar relationship
Tendency for reverse OJ
Reduced OB, possible AOB
Crossbites may be present in anterior or buccal

Maxilla often crowded, mandible well aligned/ spaced
Dentoalveolar compensation (proclined upper incisors, retroclined lower incisors)
Tendency for displacement on closing

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7
Q

What are the soft tissue features of class 3

A

Soft tissues are not normally involved in the aetiology
However can encourage dent alveolar compensation- tongue proclined upper incisors, lower lip retroclined lower incisors

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8
Q

What factors can make treating class 3 more difficult?

A

Growth tends to be unfavourable - mandibular growth continues for longer, with potential for class 3 to get worse
Anterior open bite
> number of teeth in cross bite

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9
Q

What are the 5 treatment options for class 3 pts?

A

Accept
Intercept early with URA
Growth modification
Camouflage
Combined orthognathic and ortho treatment

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10
Q

When is interceptive treatment indicated?

A

If class 3 has developed due to early contact on permanent incisors (mandibular displacement)
Only correct lateral incisor cross bite if canines are high above lateral roots (risk of resorption)

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11
Q

What are the aims of the URA with interceptive treatment?

A

Procline upper incisors over the bite
Achieve increased OB (stability of occlusion)

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12
Q

What component can be used to correct lateral incisor cross bite?

A

Z spring

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13
Q

When is growth modification considered and what is the aim?

A

At 10-14 years
Aim is to reduce or re direct mandibular growth and encourage maxillary growth (mostly has dento alveolar effect)

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14
Q

What type por functional appliance can be used

A

Reverse twin block
Protraction head gear
Bollard implants - used in late mixed/ permanent, bands from infra zygomatic crest to lower canines

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15
Q

what is involved with ortho camouflage?

A

Accepting underlying skeletal base
Aim for class 1 incisors
When growth has stopped in mild-moderate class 3 (ANB not < 0)
Pt must be able to reach edge to edge

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16
Q

What is the aim of ortho camouflage in class 3

A

Procline upper incisors
Retrocline lower incisors
Correct OJ

17
Q

What is the extraction pattern in camouflage for class 3?

A

Extract further back in upper arch and further forward in lower arch
Classic pattern - upper 5s, lower 4s

However, dental health may dictate this.

18
Q

Why full correction be avoided when still growing?

A

Cannot predict growth changes
Therefore, consider upper alignment only as extraction in lower arch could affect future treatment options (retro lining lower incisors can open up extraction sites)

19
Q

What is the orthognathic surgery approach in class 3

A

Surgical manipulation of the mandible and or maxilla to produce optimal dento facial aesthetics and function

20
Q

What must the patient be able to achieve in order to correct class 3 with URA

A

An edge to edge bite

Bds4 Ortho (12 decks)

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