Management of Skeletal Class III Malocclusion With Complex Problems of Severe Crowding and Open Bite by Two-Arch Distalization Using Clear Aligners and Miniscrews: A Case Report

Management of Skeletal Class III Malocclusion With Complex Problems of Severe Crowding and Open Bite by Two-Arch Distalization Using Clear Aligners and Miniscrews: A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Management of Skeletal Class III Malocclusion With Complex Problems of Severe Crowding and Open Bite by Two-Arch Distalization Using Clear Aligners and Miniscrews: A Case Report An Dinh-Hung Nguyen, Lam Nguyen Le, Linh My Duong This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6657780/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Clear aligner treatment is gradually becoming popular in orthodontics not only for its aesthetic appeal and convenience but also for its effectiveness in certain types of tooth movements, particularly molar distalization. There are many reports on molar distalization using or not using temporary skeletal anchorage devices; however, methods involving distalizing both upper and lower jaws to correct complex malocclusion cases are still rare. Case presentation : A 26-year-old Vietnamese patient presented with skeletal Class III malocclusion due to maxillary retrognathism. Clinical examination revealed a concave profile, Class I molar on the right and Class III on the left, bilateral class II canine. The patient exhibited anterior open bite and bilateral posterior crossbite, with severe crowding in the maxilla. The treatment plan involved non-extraction orthodontics using clear aligners, combined with skeletal anchorage miniscrews placed in the buccal shelf of the mandible to enhance distalization of both jaws simultaneously, along with maxillary expansion. The final outcome showed successful correction of malocclusion, preservation of molar relationships, established bilateral Class I canines, achievedproper tooth alignment, resultedin normal overjet and overbite. Patient’s profile has improved with reduced retrusion of upper and lower lips. Conclusions : This case report describes a treatment approach combining clear aligners and miniscrews to distalize both jaws, along with maxillary expansion, effectively managing a complex skeletal Class III malocclusion. Clear aligners treatment skeletal Class III malocclusion severe crowding two-arch distalization temporary skeletal anchorage devices Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6657780","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":477833011,"identity":"d561ce2b-d945-4e2d-8353-9851564f2db7","order_by":0,"name":"An Dinh-Hung Nguyen","email":"","orcid":"","institution":"Can Tho University of Medicine and Pharmacy","correspondingAuthor":false,"prefix":"","firstName":"An","middleName":"Dinh-Hung","lastName":"Nguyen","suffix":""},{"id":477833012,"identity":"52054c87-a381-4f75-ba54-0f3368338849","order_by":1,"name":"Lam Nguyen Le","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+0lEQVRIiWNgGAWjYBACPiQG4wMYRwKfFjYkBrMBQwKJWtgkiNPC3nv4NW+bTR4b++m0ip8/DkebMzAfvM3DcDgPpxaec2nWvG1pxWw8udtu9iQczt3ZwJZsDdRSjFOLRI6ZMW/b4cQ2htxttxmAWjYc4DGT5mFIS2zApUX+DUjL/8Q2/rfbiiFa+L/h1yLBY/yYt+1AYptE7jZmqC1sQC02uLXw5JgxzjmXDNTydrNkT1p67s5mNmPLOQa4tfCznzH+8KbMLrGfP3fjhx821rnb2Zsf3nhTIYFTC9htjGxIXANmMIlbPRAwf2D4g6wFr+JRMApGwSgYiQAApl9RnFy9jAEAAAAASUVORK5CYII=","orcid":"","institution":"Can Tho University of Medicine and Pharmacy","correspondingAuthor":true,"prefix":"","firstName":"Lam","middleName":"Nguyen","lastName":"Le","suffix":""},{"id":477833013,"identity":"13cf4d76-f464-4571-87bc-6d5e6ae42c96","order_by":2,"name":"Linh My Duong","email":"","orcid":"","institution":"Military Hospital 175","correspondingAuthor":false,"prefix":"","firstName":"Linh","middleName":"My","lastName":"Duong","suffix":""}],"badges":[],"createdAt":"2025-05-13 17:23:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6657780/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6657780/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":97336090,"identity":"a270ef70-fb74-4912-ad4a-20ef5934ceca","added_by":"auto","created_at":"2025-12-03 10:09:16","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1530970,"visible":true,"origin":"","legend":"","description":"","filename":"FinalCasereport21052025.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6657780/v1_covered_0ed88ef4-3fe0-4e32-871c-bf9a0a5a8c98.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eManagement of Skeletal Class III Malocclusion With Complex Problems of Severe Crowding and Open Bite by Two-Arch Distalization Using Clear Aligners and Miniscrews: A Case Report\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Clear aligners treatment, skeletal Class III malocclusion, severe crowding, two-arch distalization, temporary skeletal anchorage devices","lastPublishedDoi":"10.21203/rs.3.rs-6657780/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6657780/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: \u003cem\u003eClear aligner treatment is gradually becoming popular in orthodontics not only for its aesthetic appeal and convenience but also for its effectiveness in certain types of tooth movements, particularly molar distalization. There are many reports on molar distalization using or not using temporary skeletal anchorage devices; however, methods involving distalizing both upper and lower jaws to correct complex malocclusion cases are still rare.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation\u003c/strong\u003e: \u003cem\u003eA 26-year-old Vietnamese patient presented with skeletal Class III malocclusion due to maxillary retrognathism. Clinical examination revealed a concave profile, Class I molar on the right and Class III on the left, bilateral class II canine. The patient exhibited anterior open bite and bilateral posterior crossbite, with severe crowding in the maxilla. The treatment plan involved non-extraction orthodontics using clear aligners, combined with skeletal anchorage miniscrews placed in the buccal shelf of the mandible to enhance distalization of both jaws simultaneously, along with maxillary expansion. 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