Correction of Severe Class III Malocclusion by Mandibular Molar Distalization with Ramal Plates

Abstract

This retrospective investigation aims to evaluate the dentoskeletal and soft tissue changes after the distalization of the mandibular dentition using the ramal plates in nonextraction camouflage treatment of severe Class III malocclusion with a full-cusp discrepancy or more at the first molars. The sample consisted of pre- (T1) and post-treatment (T2) lateral cephalograms from 25 adult patients who were treated with the ramal plates for mandibular total distalization. The skeletal, dental, and soft tissue variables were analyzed from T1 to T2 in order to determine the effects of mandibular dentitional distalization. The mandibular first molars distalized 3.65 mm at the crown and 1.81 mm at the root. Similarly, the mandibular incisors retracted 3.32 mm at the crown and 0.81 mm at the root. Skeletally, the Wits appraisal displayed a significant increase of 1.56 mm. Also, soft tissue changes showed a significant lower lip retraction of 1.26 mm. These findings suggest that the ramal plates exhibited effective mandibular distalization in treating severe Class III malocclusion, which may be considered a viable alternative to the orthognathic surgical approach in some patients.

Keywords

• ramal plate
• severe class III malocclusion
• mandibular distalization
• nonextraction treatment