Treatment of A Class III Patient with Quad Helix Appliance and Chin Cup: A Case Report
Abstract
The mixed dentition stage provides a valuable opportunity for early orthopedic intervention in Class III malocclusion. The quad helix appliance, combined with a chin cup, may be used for maxillary expansion and sagittal control of mandibular growth during the early growth period. The purpose of this case report is to present the early treatment of a Class III malocclusion primarily associated with mandibular prognathism and transverse maxillary deficiency using a quad helix–chin cup combination. A 9-year-10-month-old girl presenting with Class III malocclusion, anterior crossbite, transverse maxillary deficiency, and a concave profile was treated with a quad helix appliance and chin cup therapy. The bite was raised with a mandibular acrylic plate to eliminate occlusal interferences, allowing maxillary expansion. Mandibular growth was controlled with a chin cup. After 25 months of treatment, positive overjet and overbite, improvement in the ANB angle, and a more balanced soft tissue profile were achieved. In prepubertal patients, particularly when cooperation is limited, a quad helix appliance that does not depend on patient compliance, combined with chin cup therapy, may contribute to favorable skeletal and dentoalveolar outcomes. However, the findings of this case report should be interpreted within the limitations inherent to single-case observations.
Keywords
References
- 1. Dibbets JMH. Mandibular rotation and enlargement. Am J Orthod Dentofacial Orthop. 1990;98(1):29-32.
- 2. Janson G, De Souza JE, Barros SE, Andrade P, Nakamura AY. Orthodontic treatment alternative to a Class III subdivision malocclusion. J Appl Oral Sci. 2009;17(4):54-63.
- 3. Campbell PM. The dilemma of Class III treatment, early or late? Angle Orthod. 1983;53(3):175-91.
- 4. Çelikoğlu M, Kiki A, Oktay H. İskeletsel Sınıf III maloklüzyonun erken dönem tedavisi (vaka raporu). Atatürk Üniv Diş Hek Fak Derg. 2009;19(3):192-7.
- 5. Chang HP, Tseng YC, Chang HF. Treatment of mandibular prognathism. J Formos Med Assoc. 2006;105(10):781-90.
- 6. Sakamoto T, Iwase I, Uka A, Nakamura S. A roentgenocephalometric study of skeletal changes during and after chin cup treatment. Am J Orthod Dentofacial Orthop. 1984;85(4):341-50.
- 7. Deguchi T, McNamara JA. Craniofacial adaptations induced by chin cup therapy in Class III patients. Am J Orthod Dentofacial Orthop. 1999;115(2):175-82.
- 8. Gökalp H, Kurt G. Magnetic resonance imaging of the condylar growth pattern and disk position after chin cup therapy: a preliminary study. Angle Orthod. 2005;75(4):568-75.
Details
Primary Language
English
Subjects
Orthodontics and Dentofacial Orthopaedics
Journal Section
Case Report
Early Pub Date
April 30, 2026
Publication Date
April 30, 2026
Submission Date
January 21, 2026
Acceptance Date
February 26, 2026
Published in Issue
Year 2026 Volume: 6 Number: 1