Abstract

Class III skeletal relationships—often associated with maxillary retrognathia, a narrow maxilla and palate, extreme upper crowding, ectopic canines, proclined upper incisors, and retroclined lower incisors—pose both functional and esthetic challenges. Over the years, a wide range of appliances and strategies have been developed to address these cases. However, many conventional approaches focus primarily on dental compensation, frequently leading to significant side effects such as worsening dental relationships or creating crowding for erupting canines. In some cases, these drawbacks result in unacceptable compromises or even contraindications for treatment.

The introduction of skeletal anchorage–based appliances has transformed the management of Class III malocclusions. By eliminating the dental side effects inherent to traditional methods, skeletal anchorage allows for optimized biomechanics and the simultaneous correction of skeletal and dental discrepancies. This approach can turn a complex, surgery-bound case into one that can be treated effectively in the clinic—expanding the boundaries of what is possible in orthodontics.

The impact is profound, not only on occlusal function and long-term oral health, but also on the psychological well-being of growing patients. Early correction can significantly boost self-esteem during critical developmental years, helping children face the world with greater confidence.

This lecture will present the latest skeletal anchorage–driven appliances and protocols, with a focus on biomechanics, appliance design, and technical considerations. Troubleshooting tips will be shared, along with fully documented case studies demonstrating superior treatment outcomes compared to conventional techniques. Long-term follow-ups will also highlight the high stability and success rates achieved with these protocols.

Participants will leave with practical, evidence-based strategies for managing even the most challenging Class III cases—transforming them from complicated malocclusions into predictable successes.

Learning Objectives

• To be able to recognise patients with severe class III discrepancies with the need of orthopaedic treatment by maxillary advancement.
• To be able to identify the amount of dental decompensation and evaluate the amount of maxillary advancement needed.
• To be able to sketch and construct the appliance needed to fulfil treatment objectives.
• To be able to utilise and use the appliance and to give proper instructions and design treatment progress in a proper way.
• To be able to measure and analyze treatment results and evaluate the prognoses.