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As for the Class III malocclusion, clinicians need to understand the age-appropriate treatment methods.
In growing children around six years old, which means IIIA or IIIB in dental age, maxillary protraction appliance (MPA) is used in the patients with maxillary retardation.
MPA contributes to the maxillary growth forward and downward by stimulating the sutures in the maxillofacial region combined with some additional appliances, for example, rapid maxillary expansion for the maxilla and Ti-made anchor plates for the mandible.

In adolescent patients, functional appliances are used, and the mandibular growth direction will be changed clockwise by extruding the molars.
This helps Class III patients to increase the ANB angle by decreasing the SNB angle.

In adults, we apply modified MEAW technique using Improved Superelastic Wires (ISW) that we invented to upright the lower molars effectively without any complicated loops.
Another characteristic of the wire is low hysteresis compared to the other Ni-Ti wires.
In this century, temporary anchorage devices (TADs) are often used to move the lower teeth distally without causing any reaction in the maxillary teeth.

If significant skeletal discrepancy remains in adults, we should choose orthognathic surgery such as sagittal splitting ramus osteotomy with or without Le Fort I osteotomy.

The number of these patients has been increasing year by year, especially in these two decades.
It can improve the skeletal relationship sagittally and frontally. Recently, we have combined digital dentistry with our conventional methods.
A CAD/CAM splint is used as the intermediate splint for repositioning the maxilla more accurately to the planned position utilizing CT images and 3D simulation.

In this talk, I will present the age-appropriate treatment method for Class III malocclusion, dividing it into the following 4 sections:

Section titles
1. Treatment in primary and mixed dentition
- Maxillary protraction
2. Treatment in adolescents and adults
- Modified MEAW technique using ISW
3. Treatment in adults_1
- TADs
4. Treatment in adults_2
- Maxillofacial surgery cases

[What the audience can learn from this content]
・Treatment for Class III malocclusion - Transition till today
・Age-appropriate treatment for Class III malocclusion
・Digital dentistry in orthognathic surgery

Speaker: Ikuo YONEMITSU, DDS, PhD, Tokyo Medical and Dental University (TMDU)
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