Transverse Autocorrection of molar inclination in Class III Patients: Case Insights on Maxillary Protraction Using Class III Palatal Plate

Abstract

Maxillary transverse deficiency is a frequent finding in growing patients with Class III malocclusion, where the relative position of the mandible to the maxilla contributes to a transverse skeletal discrepancy, often accompanied by dental compensations in both the sagittal and transverse planes. This case series examines the impact of midfacial protraction using a temporary anchorage device (TAD)-anchored Class III palatal plate in patients with relative maxillary transverse deficiency. The series highlights the occurrence of transverse autocorrection, particularly the spontaneous improvement of maxillary molar inclination, following protraction without the need for concurrent maxillary expansion. Key diagnostic considerations for maxillary transverse deficiency and the severity-based differential diagnosis are explored to guide the appropriate therapeutic approach. The potential mechanisms underlying the autocorrection of maxillary transverse discrepancies are discussed, alongside the biomechanical advantages of TAD-anchored maxillary protraction. Notably, this case series illustrates that the inclination of the maxillary molars corrected automatically after midfacial protraction, offering an alternative to conventional expansion techniques. The findings from this case series suggest that maxillary protraction without expansion may be a viable treatment option for growing Class III patients with relative maxillary transverse deficiency. However, while these preliminary observations are promising, further controlled clinical trials are necessary to validate the efficacy and long-term stability of this approach. Future studies will be crucial in confirming these outcomes and optimizing protocols for the management of transverse discrepancies in Class III malocclusions. © 2024 Elsevier Inc.