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3 When you play the games of Thrones, you win, or you die. Is there a middle ground Carlos Flores-Mir AAO June 2021. Episode 100

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Farooq Ahmed

 

When you play the games of Thrones, you win, or you die. Is there a middle ground

 Carlos Flores-Mir

 

Subject of the lecture was class 3 cases

·      Is it worth it

·      Factors to aid decision for early class 3 treatment

 

Systematic Review on early class 3 treatment Woon 2017

·      2.5mm increase overjet, 3.9o improvement in ANB – short term

·      Age less than 10 years

·      Limited evidence

·      Short erm improvement

 

 

Bone Anchored Maxillary Protraction

·      4 o ANB change in ANB systematic review Carnelis 2021

o   Older age group

o   Greater vertical control with BAMP

·      Long term effects protraction maxilla Lee 2021

o   With or without RME – greater changes with expansion

o   2 o changes in SNA short term

§  Changes not present after 3 years

·      Overjet improvement 2.5mm, however long term relapse of 1mm

 

Case

·      Skeletal maxillary protraction

·      Extraction of 2 upper units

·      Skeletal distalisation

·      Total treatment 97 months

o   OHLQoL no research, is it worth it?

 

Other perceived benefits of early class 3 treatment

·      Airway is not significantly improved  Lipani 2020

 

 

 

Conclusion

·      Uncertainty in class 3 early correction – consider what if it does not work

·       Have continuous consent, reassess after 6 months Katz 2016

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