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tient compliance was good. For retention, fixed upper and lower retainers plus Essix retainer during sleeping. Treatmentresults The post treatment extroral photographs show general improvement in the facial profile. The post treatment intraoral photo- graphs show satisfactory dental alignment. Class I canine and molar relationships (Fig 5). There was significant improvement in the maxillomandibular relationship as Cephalometrically shown by changes in the ANB angle, Wits appraisal and overjet. The maxillary arch moved forward and the mandibular had a slight backward rotation. The superimposition shows an increase in lower anterior facial height with opening of the mandibular plan angle. The maxil- lary incisors had labial proclination and the mandibular incisors were retroclined lingually (Fig 6). At the end of treatment, a normal morphologic and functional occlu- sion was obtained, with anterior guidance on lateral excursion and protrusion. Class I molar and canine relationships were ob- tained on both sides. The good interdental relationship also provided a well-balanced facial profile with lip competence. Discussion The treatment objectives were attained with the non-extraction treatment protocol. Obviously, the results reflect the effects of not only the protraction of upper anterior teeth but also the Class III elastics. The oc- clusal and facial results were good, and the patient was satisfied. The upper lip protru- sion consequent to protrusion the soft tis- sue concavity was due in part to redirection of mandible position, anterior positioning of the maxilla and retraction of mandibu- lar incisors (Fig 7).6 If the patient had not been compliant with the fixed posterior bite plan and the elastics, another option would have been to extract the mandibu- lar first premolars.7,8 However this was not a favorable treatment alternative for the de- sired soft tissue changes because the ante- rior crossbite would be corrected by retrac- tion of the mandibular incisors with little or no protrusion in the maxillary incisors; this would have produced less improve- ment in the facial profile than the nonex- traction alternative. It was stated that anteroposterior inter- maxillary elastics produce significant ver- tical adverse effects.5, 6 This can be true if there use is not properly monitored. Use of the correct resistant torques in the maxil- lary and mandibular incisors to counteract the Class III elastic forces on these teeth is essential. Nevertheless. Despite the resis- tant torque, they were substantially tipped, probably because of the large negative overjet that had to be corrected. The use of Class III elastics also can cause backward and downward mandibular rota- tion.6 Backward mandibular rotation is fa- vorable to correct Class III malocclusion, because it makes the mandible appear less prognathic and contributes to improve- ment in the facial profile.9 Conclusions Successful occlusal and esthetic correction of a Class III malocclusion in the perma- nent dentition can be accomplished with protraction of upper anterior teeth and Class III intermaxillary elastics when the patient compliance in wearing the elastics satisfactory. Once the correction is success- ful, active retention and Annual follow up are essential. Refrences 1.Franchi L, Baccetti T, McNamara JA. Postpuber- tal assessment of treatment timing for maxillary expansion and protraction therapy followed by fix- evd appliances. Am J Orthod Dentofacial Orthop 2004;126:555-68. 2.Heldt L, Haffke EA, Davis LF, The psychological and social aspects of orthognathic treatment. Am J Orthod 1982;82:318-28 3.Kondo E, Aoba TJ. Nonsurgical and nonextrac- tion treatment of skeletal Class III open bite: its long term stability. Am J Orthod Dentofacial Orthop 2000;117:730-8 4.Kuroda S, Sugawara Y, Yamashita K, Mano Takano Yamamoto T. Skeletal Class III oligodontia patient treated with titanium screw anchorage and orthognathic surgery. Am J Orthod Dentofacial Or- thop 2005;127:730-8 5.Miyajima K, Lizuka T. Treatment mechanics in Class III open bite malocclusion with tip edge tech- nique. Am J Orthod Dentofacial Orthop 1996;110:1-7 6.De Albay Levy JA, Chaconas SJ, Capputo AA. Effect of orthodontic intermaxillary Class III mechanics on craniofacial structures. Part II –computerized ceph- alometrics. Angle Orthod 1979;49:29-36 7.Costa Pinho TM, Ustrell Torrent JM, Correia Pinto- JG. Orthodontic camouflage in the case of skeletal Class III malocclusion. World J Orthod 2004;5:213-23 8.Janson G, de Souza JE, Alves FA, Andrade P Jr, Nakamura A, de Freitas MR, et al. Extreme dento- alveolar compensation in the treatment of Class III malocclusions. Am J Orthod Dentofacial 9.Orthop 2005;128:787-94 9-Moullas AT, Palomo JM, Gass JR, Amberman BD, White J, Gustovich D. Nonsurgical treatment of a patient with Class III malocclusion. Am J Orthod Dentofacial 2006;129(suppl):S111-8. Dr. Khaled Abouseada, BDS, MS, Or- thodontics cert, is consultant orthodon- tic who is involved in private practice in Saudi Arabia, Bahrain and Egypt plus teaching orthodontic in BMC and SA- MAT. He graduated from Alexandria University in 1993, Fellow of the World Federation of orthodontics and mem- ber in multiple regional and internation- al orthodontic associations. Dr. Khaled has to his credit, various publications in national and international journals. He has lectured at many international and national dental and orthodontic fo- rums. Winner of I LOVE MY DENTIST AWARD 2010 and 2011 and short listed winner of best orthodontic case award in MENA area 2010 and 2011. Being the proud holder of 4 international certifi- cations in different CAD CAM aligners systems and also practicing CAD CAM lingual and labial orthodontics, he is also a certified trainer for CAD CAM aligners; these years of practice make him one of the most experienced doctors in the continent to have practiced orth- odontic CAD/CAM therapy. Asnani Dental Clinic Jeddah, Saudi Arabia. khaledseada@yahoo.com Contact Information By Dr. Khaled Abouseada W e are in for a real treat today. I have the honor to introduce our guest who has been the driving force behind Orth- odontic practice for many years. He is the person who knows the whole history of how we got to where we are today: the sto- ries, the challenges and the little known se- crets. Not only that but he's a remarkably professional lecturer, a Visiting Professor who has extensively profounder in giving lectures and courses all over the world spe- cifically in the United States, Europe, Mid- dle East and North Africa. Based on his knowledge and enthusiasm, he is eminent- ly qualified to speak to us today about him- self and his scientific experience. Please join me in giving a very warm welcome to Professor Joseph Bouserhal. Dr. Joseph Bouserhal is Professor in the De- partment of Orthodontics at Saint-Joseph University and maintains a private orth- odontic practice in Beirut. He was former Head and Director of the Program (1995- 2010) and President of the Lebanese and Arab Orthodontic Societies. Actually, he is a Research Associate at the University of Toulouse, a Member of the Executive Com- mittee of the World Federation of Ortho- dontists, an Affiliate Member of the Angle Society of Orthodontics, East Component and a Fellow of the Tweed Foundation for Orthodontic Education and Research. He earned a Doctor in Dental Surgery De- gree from Saint-Joseph University, a Mas- ter Degree in Orthodontics from the Uni- versity of Louvain, a Continuing Education Diploma in Orthodontics from the Univer- sity of Southern-California, a Diploma of Specialist in Lingual Orthodontics from the University of Paris VII, a Diploma in 3D Imaging and a Diploma in Dental Clinical Research from the University of Toulouse. He is a PhD candidate at the University of Li ge in Belgium. I am also delighted to mention that in ad- dition to all the above-mentioned achieve- ments, he also published articles in local and international journals and successfully conducted many research projects leading to a master or PhD degrees. His main inter- ests are Vertical Dimension Control, Treat- ment of Asymmetries, Adult Orthodontics, Transverse Dimension, Mini-implants and 3D Imaging. You chose orthodontics as your first pref- erence, how did take such a decision? When I was at my 4th year in the dental school at Saint-Joseph University, we be- gun our undergraduate orthodontic teach- ing with Professor Peter Riscallah, founder of the department and the Lebanese Orth- odontic Society, who was a highly culti- vated man, eager to teach and multitalent- ed, and later on with Professor Far s Abou Obeid who was so communicative, humble and open-minded. Both teachers get me to know this discipline and to be attached to it. How far would you expect yourself to con- tribute to this profession? In general, a contribution could be in an academic direction through clinical teach- ing and research or in a professional one by integrating local, regional or internation- al orthodontic organizations. My contribu- Orthodontics has evolved dramatically during the past ten years Fig 4. Progress 2 after 9 months, at the beginning of the fin- ishing stage. Fig 5. Final photographs and radiographs show normal overbite and overjet relationship,elimination of anterior cros Fig 6. Posttreatment cephalometric tracing. Fig 7. Profile before and after.. 14 DENTAL ORTHO TRIBUNE DENTAL TRIBUNE Middle East & Africa Edition | Jan-Feb 2013