A late adolescent patient presented with a Class III malocclusion on a skeletal Class III base, complicated by severe upper arch and moderate lower arch crowding, reverse overjet, anterior and bilateral posterior crossbites with displacement, proclined upper incisors, retroclined lower incisors, distally tipped lower canines and non-coincident centrelines. Treatment was undertaken on an extraction basis by employing the use of an upper removable appliance with Z-springs and posterior bite blocks to correct the anterior crossbite, quad helix and jockey arch for arch expansion, and pre-adjusted edgewise fixed appliance to level and align, space closure and achieve a mutually protective functional occlusion. This paper discussed the rational and evidences behind the treatment employed.
The study aimed to assess patient satisfaction with their orthodontic treatment outcome and type of cases accepted for orthodontic treatment at the Faculty of Dentistry, University of Malaya (UM) and to audit the quality of treatment outcome. The standard set were 100% patient should be satisfied with their treatment outcome and less than 5% of the proportion of cases should fall in the “worse/no different’ category with a mean reduction of Peer Assessment Rating (PAR) score being greater than 70%. Records of cases that had completed orthodontic treatment were traced. Survey forms were sent to 150 patients that had met the inclusion and exclusion criteria. Their intact study models were assessed for the Index of Orthodontic Treatment Need (IOTN) and PAR. 21.3% responded to the survey, of which 59.4% had treatment involving fixed appliances and 37.6% had either removable or functional appliances or retainers. 93.8% respondents were satisfied with their dental alignment and 87.5% with the overall treatment results. For the dental health component of the IOTN, 63.3% had ‘definite need’ and 21.1% had ‘borderline need’ for treatment. For the aesthetic component of the IOTN, 24.2% had ‘definite need’ and 32.0% had‘borderline need’ for treatment. For the PAR, 8.0% had an outcome of “worst/no different”. The mean PAR reduction score was 75.3%. In conclusion, although majority were satisfied with their treatment results, there is still a need to improve on the standard of care to address the issues of the minority who were not satisfied with the treatment outcome.