EC Dental Science

Case Study Volume 22 Issue 6 - 2023

A Case Study Utilizing the Removable Osseo-Restoration ApplianceTM for Early Treatment of a Class 3 Malocclusion in the Mixed Dentition

David Buck*

Balance Epigenetic Orthodontics, TMJ-Facial Orthopedics-Sleep, Lynnwood, WA, United States

*Corresponding Author: David Buck, Balance Epigenetic Orthodontics, TMJ-Facial Orthopedics-Sleep, Lynnwood, WA, United States.
Received: April 24, 2023; Published: May 10, 2023



Introduction: This case study demonstrates the skeletal and dental changes achieved using the Removable Osseo-Restore ApplianceTM (RORA) in an 8-year-old male with an early Class III malocclusion.

Aim: To evaluate the effectiveness of the RORA appliance in correcting the Class III malocclusion.

Methods: The RORA appliance is a removable maxillary device worn full time, including while eating. The device features two sagittal screws that are turned twice a week until 5 - 7 mm of separation is achieved. The patient undergoes evaluation appointments every four weeks. Cephalometric tracings were taken before and after treatment and compared to assess positive skeletal changes, facial growth, and anterior crossbite correction.

Results: The cephalometric comparisons revealed positive skeletal changes and correction of the anterior crossbite. Furthermore, the treatment produced different effects than those typically achieved with facemask treatment.

Conclusion: The RORA appliance was effective in the early treatment of a Class III malocclusion.

Keywords: Class III Malocclusion; Interceptive Orthodontic Treatment; Jaw Orthopedics; Removable Orthopedic Appliances; Mixed Dentition; Sagittal Removable Appliances

  1. Alhammadi MS., et al. “Global distribution of malocclusion traits: A systematic review”. Dental Press Journal of Orthodontics 6 (2018): 40.e1-40.e10.
  2. Westwood PV., et al. “Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances”. American Journal of Orthodontics and Dentofacial Orthopedics 3 (2003): 306-320.
  3. Woon SC and Thiruvenkatachari B. “Early orthodontic treatment for Class III malocclusion: A systematic review and meta-analysis”. American Journal of Orthodontics and Dentofacial Orthopedics 1 (2017): 28-52.
  4. Kongo Elona. “Treatment of Maxillary Retrusion-Face Mask with or without RPE?” Balkan Journal of Dental Medicine 22 (2018): 93-97.
  5. Zere E., et al. “Developing Class III malocclusions: challenges and solutions”. Clinical, Cosmetic and Investigational Dentistry 10 (2018): 99-116.
  6. Jang SJ., et al. “Relationship between the lingual frenulum and craniofacial morphology in adults”. American Journal of Orthodontics and Dentofacial Orthopedics 4 (2011): e361-e367.
  7. Guay AH., et al. “A radiographic study of tongue posture at rest and during the phonation of /s/ in class III malocclusion”. The Angle Orthodontist 1 (1978): 10-22.
  8. Staudt CB and Kiliaridis S. “Different skeletal types underlying Class III malocclusion in a random population”. American Journal of Orthodontics and Dentofacial Orthopedics 5 (2009): 715-721.
  9. Stellzig-Eisenhauer A., et al. “Treatment decision in adult patients with Class III malocclusion: Orthodontic therapy or orthognathic surgery?” American Journal of Orthodontics and Dentofacial Orthopedics 1 (2002): 27-37.
  10. Guyer EC., et al. “Components of class III malocclusion in juveniles and adolescents”. The Angle Orthodontist 1 (1986): 7-30.
  11. Baccetti T., et al. “Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and facemask therapy”. American Journal of Orthodontics and Dentofacial Orthopedics 3 (1998): 333-343.
  12. Nanda RS and Ghosh J. “Longitudinal growth changes in the sagittal relationship of the maxilla and mandible”. American Journal of Orthodontics and Dentofacial Orthopedics 1 (1995): 79-90.
  13. Nanda R. “Biomechanical and clinical considerations of a modified protraction headgear”. American Journal of Orthodontics 2 (1980): 125-139.
  14. Kapust AJ., et al. “Cephalometric effects of face mask/expansion therapy in Class III children: A comparison of three age groups”. American Journal of Orthodontics and Dentofacial Orthopedics 2 (1998): 204-212.
  15. Brandão M., et al. “Clinical and quantitative assessment of headgear compliance: A pilot study”. American Journal of Orthodontics and Dentofacial Orthopedics 2 (2006): 239-244.
  16. Cha KS. “Skeletal changes of maxillary protraction in patients exhibiting skeletal class III malocclusion: a comparison of three skeletal maturation groups”. The Angle Orthodontist 1 (2003): 26-35.
  17. Ngan PW., et al. “Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction”. Seminars in Orthodontics 4 (1997): 255-264.
  18. D Abernathy., et al. “White Paper on the Efficacy of the Osseo-Restore™ Appliance to Effect Skeletal Patency and Growth in The Anterior Maxilla Moulton (2021).
  19. Chervin RD., et al. “Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems”. Sleep Medicine 1 (2000): 21-32.
  20. Zaghi, S., et al. “Assessment of posterior tongue mobility using lingual‐palatal suction: Progress towards a functional definition of ankyloglossia”. Journal of Oral Rehabilitation 6 (2021): 692-700.
  21. Ovsenik M., et al. “A 2D ultrasound evaluation of swallowing in children with unilateral posterior crossbite”. The European Journal of Orthodontics 6 (2013): 665-671.
  22. McNamara JA Jr. “Components of class II malocclusion in children 8-10 years of age”. The Angle Orthodontist3 (1981): 177-202.

David Buck., et al. "A Case Study Utilizing the Removable Osseo-Restoration ApplianceTM for Early Treatment of a Class 3 Malocclusion in the Mixed Dentition". EC Dental Science 22.6 (2023):11-19.