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2019 Annual Session Conference

Class III Treatment in Adults: Surgery or Compensation? How Palatal TADs May Help Us to Widen the Possibilities

May 6, 2019 3:55pm ‐ May 6, 2019 4:25pm


Adult orthodontic treatment involves challenging biomechanical considerations, due to the lack of growth potential. Skeletal anchorage has made it possible to perform complex tooth movements. This lecture describes the nonsurgical treatment of adult class III patients using mini-implants for compensatory mechanics in terms of upper full arch mesialization. However, combined orthodontic-surgical treatment is indicated for those patients exhibiting a extreme skeletal class III. When treating pronounced dentoalveolar compensation of a skeletal class III malocclusion, preoperative decompensation frequently requires the extraction or distalization of maxillary lateral teeth and retraction of the incisors. In this context, maximum anchorage of the maxillary molars is frequently necessary to attain the significant increase in negative overjet that is desired. The second aim of this lecture is to discuss the design of skeletal molar anchorage modalities using mini-implants for en-masse retraction and pre-operative decompensation.

Learning Objectives:

  • Recognize treatment strategies to mesialize all upper teeth to compensate a mild to moderate class III.
  • Recognize proper anchorage modalities for en-masse retraction.
  • Identify proper insertion sites for palatal TADs.


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