3. Occlusal Rehabilitation of a Pseudo Class III Malocclusion

Case Summary

Male · 60s

The patient had lived for decades believing he had a skeletal Class III malocclusion.

Following multiple unsuccessful dental treatments, he relied on an ill-fitting removable prosthesis,
which ultimately led to severe deterioration of the remaining abutment teeth.

Clinical and radiographic assessment revealed a pseudo Class III occlusion,
rather than a true skeletal discrepancy.

While mandibular bone quality was favourable, the posterior maxilla showed limited bone availability due to sinus pneumatization.

OPG - BEFORE

INTRA ORAL - BEFORE

Treatment Objectives

• Correction of pseudo Class III occlusal relationship

• Restoration of posterior support through vertical dimension increase

• Horizontal repositioning of occlusion to achieve balanced force distribution

• Creation of a subtle anterior overjet for a more natural facial profile

• Preservation of salvageable natural teeth where feasible

OPG - AFTER

INTRA ORAL - AFTER

Treatment Approach

A prosthetic-driven rehabilitation strategy was adopted.

Posterior maxillary implant placement was performed in conjunction with bone grafting to compensate for sinus-related bone deficiency.

Following vertical augmentation, the occlusal plane was repositioned horizontally to correct the functional Class III pattern.

Natural teeth with favourable prognosis were preserved,
and a controlled anterior overjet was established to guide a more harmonious occlusion and facial appearance.