{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T15:21:38Z","timestamp":1751469698566,"version":"3.40.5"},"reference-count":13,"publisher":"Pensoft Publishers","issue":"4","license":[{"start":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T00:00:00Z","timestamp":1725062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>Skeletal class III malocclusion is a therapeutic challenge in orthodontic practice. Reverse functional appliances such as reverse twin block (RTB) are used to correct class III skeletal and occlusal disharmonies associated with functional anterior shift in growing patients. However, treatment options become limited with increasing age, especially when patients desire nonsurgical and nonextraction camouflage treatment. This report illustrates the successful nonsurgical treatment of class III malocclusion during adolescence and adulthood, exacerbated by a functional anterior shift that resulted in overclosure of the mandible. A modified fixed RTB was utilized to posture the mandible backwards, thereby inducing active clockwise rotation of the mandible. After treatment, patients demonstrated significantly improved maxillomandibular relationships, well-maintained stable occlusion, and facial esthetics. Satisfactory occlusal, esthetic, and functional outcomes achieved in the present cases underline the fact that dentoalveolar changes induced by fixed RTB can be utilized even past a patient\u2019s peak pubertal growth period to obtain changes that aid in correcting a class III malocclusion. A synergistic combination of modified fixed RTB therapy accompanied by comprehensive fixed mechanotherapy is a viable treatment alternative for the correction of aptly selected mild to moderate skeletal class III malocclusions associated with functional anterior shift, anterior crossbites, and mandibular overclosure.<\/jats:p>","DOI":"10.3897\/folmed.66.e119060","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T07:04:14Z","timestamp":1725951854000},"page":"555-567","source":"Crossref","is-referenced-by-count":2,"title":["Nonsurgical class III correction in adolescence using modified fixed reverse twin-block therapy and fixed appliances \u2013 a case series"],"prefix":"10.3897","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8342-931X","authenticated-orcid":true,"given":"Harpreet","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pinaki","family":"Roy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj Kumar","family":"Maurya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poonam","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranav","family":"Kapoor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanmay","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2024,8,31]]},"reference":[{"key":"119060_B1","unstructured":"1. Guyer EC, Ellis EE 3rd, McNamara Jr JA, et al. Components of class III malocclusion in juveniles and adolescents. Angle Orthod 1986;56(1):7\u201330."},{"key":"119060_B2","doi-asserted-by":"crossref","unstructured":"2. Jang W, Shin C, Hwang S, et al. Nonsurgical treatment of an adult with a skeletal class III malocclusion combined with a functional anterior shift, severely overclosed vertical dimension, and a reverse smile. Am J Orthod Dentofacial Orthop 2020; 157(4):561\u201370.","DOI":"10.1016\/j.ajodo.2019.01.029"},{"key":"119060_B3","unstructured":"3. Lin J, Gu Y. Preliminary investigation of nonsurgical treatment of severe skeletal class III malocclusion in the permanent dentition. Angle Orthod 2003; 73(4):401\u201310."},{"key":"119060_B4","doi-asserted-by":"crossref","unstructured":"4. Ngan P, Moon W. Evolution of class III treatment in orthodontics. Am J Orthod Dentofacial Orthop 2015; 148(1):22\u201336.","DOI":"10.1016\/j.ajodo.2015.04.012"},{"key":"119060_B5","unstructured":"5. Liu H, Li J. Non-surgical treatment of an Angle class III malocclusion in adults. Int J Clin Exp Med 2013; 6(9):738\u201346."},{"key":"119060_B6","unstructured":"6. Hisano M, Ohtsubo K, Chung CJ, et al. Vertical control by combining a monoblock appliance in adult class III overclosure treatment. Angle Orthod 2006; 76(2):226\u201335."},{"key":"119060_B7","unstructured":"7. Clark WJ. Treatment of class III malocclusion. In: Clark WJ, editor. Twin block functional therapy: Applications in Dentofacial Orthopaedics. 2nd ed. Mosby; London: 2002. pp. 217\u201330."},{"key":"119060_B8","doi-asserted-by":"crossref","unstructured":"8. Tseng LL, Chang CH, Roberts WE. Diagnosis and conservative treatment of skeletal class III malocclusion with anterior crossbite and asymmetric maxillary crowding. Am J Orthod Dentofacial Orthop 2016; 149(4):555\u201366.","DOI":"10.1016\/j.ajodo.2015.04.042"},{"key":"119060_B9","doi-asserted-by":"crossref","unstructured":"9. Kidner G, DiBiase A, DiBiase D. Class III twin blocks: a case series. J Orthod 2003; 30(3):197\u2013201.","DOI":"10.1093\/ortho\/30.3.197"},{"key":"119060_B10","unstructured":"10. Seehra J, Fleming PS, Dibiase AT. Reverse twin block appliance for early dental class III correction. J Clin Orthod 2010; 44(10):602\u201310; quiz 621."},{"key":"119060_B11","doi-asserted-by":"crossref","unstructured":"11. Fareen N, Alam MK, Khamis MF, et al. Treatment effects of Reverse Twin-Block and Reverse Pull Face Mask on craniofacial morphology in early and late mixed dentition children. Orthod Craniofac Res 2017; 20(3):134\u20139.","DOI":"10.1111\/ocr.12179"},{"key":"119060_B12","doi-asserted-by":"crossref","unstructured":"12. Singh H, Kapoor P, Sharma P, et al. Skeletal class III correction in permanent dentition using reverse twin block appliance and fixed mechanotherapy. Saudi Dent J 2018; 30(4):379\u201388.","DOI":"10.1016\/j.sdentj.2018.05.009"},{"key":"119060_B13","doi-asserted-by":"crossref","unstructured":"13. Ngan P, He H. Effective maxillary protraction for class III patients. In: Nanda R, Kapila S, editors. Current Therapy in Orthodontics. 1st ed. 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