Maxillary development revisited: relevance to the orthopaedic treatment of Class III malocclusions

Normal development of the maxilla results not only from movements of its constituent skeletal units and bony apposition-resorption superficially, but also from the specific development of the antero-lateral regions. In Class III cases, correction of the skeletal dysmorphosis requires not only that t...

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Bibliographic Details
Published in:European journal of orthodontics 1997-06, Vol.19 (3), p.289-311
Main Author: Delaire, J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Bone Resorption
Child
Child, Preschool
Deglutition - physiology
Dentistry
Extraoral Traction Appliances
Facial Muscles - physiology
Humans
Infant
Infant, Newborn
Malocclusion, Angle Class III - physiopathology
Malocclusion, Angle Class III - surgery
Malocclusion, Angle Class III - therapy
Mastication - physiology
Maxilla - growth & development
Maxillofacial Development
Mouth - physiology
Orthodontic Appliances
Osteogenesis
Respiration - physiology
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Summary:Normal development of the maxilla results not only from movements of its constituent skeletal units and bony apposition-resorption superficially, but also from the specific development of the antero-lateral regions. In Class III cases, correction of the skeletal dysmorphosis requires not only that the maxilla is in a correct position (in relation to the mandible) and that the correct occlusion is achieved, but also that there is good development of the exo-peri-premaxilla. This requires normalization of muscular posture (labio-mental, lingual, velo-pharyngeal) and of orofacial functions (nasal ventilation, swallowing, mastication). Postero-anterior traction using an orthopaedic mask can only accomplish part of the treatment of Class III. The action must always be complimented by other therapy aimed at correcting the underdevelopment of the antero-lateral regions. Facemask therapy is not only simple sagittal distraction, but is truly a method for treatment of Class III which is well understood and achieves ellent results. Taking into account the great diversity of anatomical forms of Class III malocclusion, it is not surprising that extra-oral postero-anterior traction gives widely varying results. The quality, however, depends principally on the method used. Orthodontists must not hesitate to call for the assistance of a surgeon each time the functional treatment is insufficient, particularly in cleft patients where the results depend more on surgical procedures, both primary and secondary, than on dentofacial orthopaedics.
ISSN:0141-5387
1460-2210
DOI:10.1093/ejo/19.3.289