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Australasian Dentist : October 2008
CASE STUDY March 2008 Facial changes manifest in the advancement of nasomaxillary complex, improved nasal and labial harmony and softening of mandibular prominence due to downward rotation. Changes in Facial Profile (1997) proposal of functional appliances seems much more desirable. After a comprehensive review on maxillary growth, he declares that the craniofacial skeleton is an ‘exact reflection’ of cephalic posture and function, and therefore correction of the dysfunctions must accom- pany correction of skeletal form. The Fränkel III function regulator (FR-3) is a functional appliance designed to counteract the muscular forces restricting maxillary development. Few studies have assessed the FR-3; despite its skel- etal effect on the maxilla not having as yet been conclusively proven, Falck and Zimmermann- Menzel (2008) have demonstrated an ‘obvious’ effect on horizontal maxillary developmentiv . Additional studies have also observed changes in the position and/or shape of the mandiblev . The Interceptive Class III Appliance(i-3™), October 2006 March 2006 As indicated by the positive results using the i-3™ in this case, there exist sufficient grounds to subvert the conventional hierarchy of treatment that seems to have been tacitly accepted by most. We are compelled not only as dental professionals, but also as scientists, to orientate ourselves towards a more rational, evidence-based ap- proach. Especially in light of muscular forces being regarded as the principle factor in relapse following mandibular setbackvii, it simply stands to reason that treatment of Class III should also address some of the early (functional) causes of the dysmor- phosis. An organic problem, however, calls for an organic approach to treatment: we must remember that the various treatment modalities in our armoury are not mutually exclusive, and should not be afraid to choose any of the options available, provided they are congruent to the case. incorporates a Fränkel cage into its design for maxillary development, with an offset Class I/II incisor preset; high extended ‘reflex’ sides to discourage anterior mandibular posture; and a positive tongue position elevator to raise the tongue position in conjunction with the ubiq- uitous tongue tag. The i-3™ seems to have been used to great effect by Dr. Arturo Alvarado Ros- sano, in conjunction with maxillary expansion and a selective grinding technique.vi u Email GAP for a complete list of references. firstname.lastname@example.org 68 Australasian Dentist
July August 2008