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Pseudo-Class III Treatment — ORE Part 1 MCQ

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ModerateOrthodonticsPseudo-Class III TreatmentORE Part 1

A patient has an anterior crossbite with a reverse overjet of 4 mm. In centric relation, the incisors are edge-to-edge and the mandible is not prognathic. Cephalometric assessment shows no clinically significant skeletal discrepancy. The upper incisors are retroclined and the lower incisors are proclined. What is the most appropriate treatment approach?

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Correct answer: B — Orthodontically procline the upper incisors and retrocline the lower incisors

Explanation lettering: B = shown as A · A = shown as B · E = shown as D · D = shown as E

The correct answer is A. The edge-to-edge relationship in centric relation, normal skeletal assessment, retroclined upper incisors and proclined lower incisors identify a pseudo-Class III malocclusion. Management is orthodontic correction of the dentoalveolar relationship: procline the upper incisors and, where appropriate, retrocline the lower incisors to obtain a positive overjet. Maxillary advancement (B) and mandibular setback (C) are reserved for clinically significant skeletal Class III discrepancies, which the stem excludes. Lower-incisor extraction (D) is not indicated solely to manage this dentoalveolar crossbite and could compromise the occlusion. Observation until growth completion (E) is inappropriate because the problem is orthodontically correctable and continued functional displacement may perpetuate the crossbite.

Reference: Ngan P, Moon W. Diagnosis and Treatment of Pseudo-Class III Malocclusion. 2014. https://pubmed.ncbi.nlm.nih.gov/25525526/