Correction of skeletal Class III in mixed dentition: A case report

Abstract

Anterior crossbite rarely resolves spontaneously, and early orthodontic intervention is often necessary to support normal maxillofacial development. The present case involved a patient with anterior crossbite and skeletal Class III malocclusion, characterized by a concave facial profile. In both habitual maximum intercuspation (HMI) and centric relation (CR), the molar and canine relationships were classified as Angle Class III, with a mesial terminal plane in the second primary molars. Initial cephalometric analysis confirmed skeletal Class III malocclusion, with upright and retruded maxillary incisors, and well-positioned mandibular incisors relative to the apical base. The soft tissue profile was concave, while the skeletal profile appeared straight. Orthopedic intervention was initiated during the mixed dentition phase. The treatment plan included rapid maxillary expansion (RME) using the McNamara appliance, followed by maxillary protraction (MP) with a facial mask. Follow-up continued through the completion of craniofacial growth. The chosen approach was effective in correcting the malocclusion during the mixed dentition phase, demonstrating the utility of early orthopedic intervention in managing skeletal Class III discrepancies.