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
