Protração maxilar como tratamento precoce da má oclusão classe iii

Abstract

INTRODUCTION: The class III malocclusion is defined by the anterior position of the lower first molar in relation to the upper one, the origin may be skeletal, dental, or interactions between them. The skeletal involvement makes the class III malocclusion, one of the most difficult problems to treat, however, when caused by a maxillary deficiency, an early treatment through maxillary protraction can present good results. Maxillary protraction aims to rebalance maxillary growth and correct malocclusion. AIM: To review the literature on the early treatment of Class III malocclusion by maxillary protraction. METHODOLOGY: To obtain this literature review, searches were performed in the following databases: Pubmed, Lilacs, Bireme, Scielo. Studies published from 2005 to 2020, in English, Spanish or Portuguese were included. The types of studies selected for full evaluation were clinical trials, cohort studies, case-control studies, case report and case series. The keywords used for the research were: "Class III malocclusion", “Maxillary Protraction”, “Facial Mask”, “Maxillary disjunction”. RESULTS: In the initial search, 69 manuscripts that discussed the topic were identified, after applying the inclusion criteria, ten studies were included and analyzed in their entirety. Most studies indicate the use of a face mask associated with expansion devices. The force used, through extra-oral elastics, for maxillary protraction ranged from 300 to 600 grams on each side. The results together indicate that the early treatment of class III malocclusion, through maxillary protraction, is beneficial and possible, regardless of the force application protocols and devices used. The use of a skeletal anchorage may be associated with a reduction in treatment time. CONCLUSION: Maxillary protraction with a facial mask, associated with maxillary disjunction, is one of the most used treatments for class III malocclusion. Even in the case of a multifactorial condition, it is possible to achieve a good prognosis, aesthetic and functional gains, when the problem is treated early phases.