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Introduction A skeletal Class III malocclusion is one of the most difficult anomalies to treat. Class III malocclusion with retruded maxilla can be orthopedically corrected with facemask in deciduous or mixed dentition in mild to moderate cases. The treatment should be carried out as early as possible before the malocclusion becomes severe. Cases’ report These are two case reports of successful treatment of developing skeletal class III malocclusion, on a 7-year-old female patient in early mixed dentition and on a 9-year-old female patient in mixed dentition. Both present a skeletal Class III due to a deficient maxilla. The treatment plan included protraction of the maxilla by a reverse pull Delaire type facemask. The post treatment results showed significant improvement in Class III skeletal relationship and the facial profile, with the correction of the overjet. Discussion The purpose of early orthodontic treatment of Class III is to intercept the developing malocclusion and redirect it to physiological development. Cases that show skeletal maxillary retrognathism are cases opt for treatment with facemask. The latter acts by promoting maxillary growth while restricting mandibular growth. Thus, it improves the skeletal relationships, minimizes excessive dental compensation and improves occlusal function. It also provides more pleasing facial aesthetics and may eliminate the necessity for orthognathic surgery treatment in some cases. Conclusion Early Class III treatment can be done successfully when proper diagnosis and proper treatment plan are carried out carefully.

Hyperplasia of articular eminence is a rare condition embedded in the structural incompatibility disorders of temporomandibular joint, where the joint surfaces are altered in shape, resembling a pseudo-ankylosis case. This disorder is normally associated with a history of trauma, leading to deviation of the condyle from its normal trajectory. In the present case, a 49-years-old male patient, complaining of mouth opening limitation and pre-auricular pain after a sport trauma in a soccer game (face vs. ball) 10 years ago. Clinically, presented a 15 mm mouth opening with left chin deviation associated with retrognathism and facial asymmetry. At the time of the examination, the patient had no pain in the temporomandibular joint or masticatory muscles. After clinical examination and imaging, a surgical treatment was proposed based on Kaban's protocol in which an eminectomy was performed followed by coronoidectomy, obtaining a 33 mm mouth opening after 14 months of follow up.

This report presents a case of a 12-year-old girl with maxillary deficiency, mandibular prognathism, and facial asymmetry, undergoing growth hormone (GH) therapy due to idiopathic short stature. Children of short stature with or without GH deficiency have a deviating craniofacial morphology with overall smaller dimensions; facial retrognathism, especially mandibular retrognathism; and increased facial convexity. However, a complete opposite craniofacial pattern was presented in our case of a skeletal Class III girl with idiopathic short stature. The orthodontic treatment goal was to inhibit or change the direction of mandibular growth and stimulate the maxillary growth of the girl during a course of GH therapy. Maxillary protraction and mandibular retraction were achieved using occipitomental anchorage (OMA) orthopedic appliance in the first stage of treatment. In the second stage, the patient was treated with a fixed orthodontic appliance using a modified multiple-loop edgewise archwire technique of asymmetric mechanics and an active retainer of vertical chin-cup. The treatment led to an acceptable facial profile and obvious facial asymmetry improvement. Class I dental occlusion and coincident dental midline were also achieved. A 3½-year follow-up of the girl at age 18 showed a stable result of the orthodontic and dentofacial orthopedic treatment. Our case shows that the OMA orthopedic appliance of maxillary protraction combined with mandibular retraction is effective for correcting skeletal Class III malocclusion with midface deficiency and mandibular prognathism in growing children with idiopathic short stature undergoing GH therapy.

金沢大学医学部附属病院歯科口腔外科, Purpose: The purpose of this study was to objectively evaluate hypoesthesia of the upper lip following Le Fort I osteotomy in combination with mandibular osteotomy with trigeminal somatosensory evoked potential (TSEP). Subjects and methods: The subjects consisted of 25 patients with mandibular prognathism with maxillary retrognathism mandibular prognathism with or without asymmetry, who underwent Le Fort I osteotomy in combination with sagittal split ramus osteotomy (SSRO) or intraoral vertical ramus osteotomy (IVRO).Trigeminal nerve hypoesthesia at the region of the upper lip was assessed bilaterally by the TSEP method. The electrodes were placed exactly above the highest point of the vermilion border and on the mucosa of the upper lip. An electroencephalograph recording system (Neuropack Sigma; Nihon Koden Corp., Tokyo, Japan) was used to analyze the potentials. Each patient was evaluated preoperatively and then postoperatively at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year. Results: The average measurable period and standard deviation of TSEP of the upper lip was 7.8 ± 10.7 weeks following Le Fort I osteotomy, TSEP of the lower lip was 4.6 ± 9.2 weeks in the patients who underwent SSRO with Le Fort I osteotomy, and 1.2 ± 0.4 weeks in the patients who underwent IVRO with Le Fort I osteotomy. Conclusion: This study objectively proved that hypoesthesia could appear in the upper lips following Le Fort I osteotomy with TSEP. The measurable period for the upper lip following Le Fort I osteotomy tended to be longer than that for the lower lip in the patients who underwent SSRO and IVRO with Le Fort I osteotomy. © 2007 Mosby, Inc. All rights reserved.