Early Treatment of Class III Malocclusion with a Tandem Traction Bow Appliance (TTBA) – A Progress Case Report

Since Class III malocclusion is progressive, the facial growth of Class III malocclusion deteriorates with age. Class III malocclusion is characterised by a deviation in the sagittal relationship of the maxilla and the mandible, which is characterised by a deficient maxilla, a retrognathic mandible, or a combination of the two. Early orthopaedic treatment of Class III malocclusions, at the end of primary dentition or the beginning of mixed dentition, prior to growth spurt, allows for successful outcomes by providing facial balance, modifying maxillofacial growth and development, and, in many cases, preventing future surgical treatment by increasing stability. There are numerous treatment approaches available in the literature for orthopaedic and orthodontic treatment of class III malocclusion, including intraoral and extraoral appliances. Because of its physical appearance, the main issue with extraoral anchorage has been patient compliance. The case report describes an intraoral modified tandem appliance for maxillary protraction that has been clinically used to achieve successful results without relying heavily on patient cooperation.