Received: 12.01.2026
Accepted: 10.02.2026
Published online: 30.03.2026
UDC: 616.314-089.23-036.8
DOI: 10.70113/1815-9443.2026.86.20.001
RELAPSE OF ORTHODONTIC TREATMENT IN A PATIENT WITH VERTICAL GROWTH PATTERN AND BORDERLINE SKELETAL CLASS III: THE ROLE OF THIRD MOLARS AND DIAGNOSTIC FACTORS (CLINICAL CASE)
Dosberdiyeva G.T., Karimova A.A., Dosmatova K.R., Valov K.M., Bimenov K.S.
NJSC “Asfendiyarov Kazakh National Medical University”, Almaty, Kazakhstan
Introduction. Underestimation of the skeletal component in patients with a vertical growth pattern and borderline skeletal Class III increases the risk of selecting an inadequate treatment strategy and subsequent relapse. Without comprehensive cephalometric assessment, excessive dentoalveolar compensation (retroclination of mandibular incisors and molar extrusion) may occur, reducing treatment stability. Eruption of third molars does not always directly cause crowding;
however, in predisposed patients, it may exacerbate crowding due to a mesial force vector. In individuals with a thin periodontal biotype, this additionally increases the risk of gingival recession and inflammatory changes.
Aim. To determine the causes and mechanisms of orthodontic treatment relapse associated with diagnostic errors and eruption of third molars in patients with a vertical growth pattern and borderline skeletal Class III.
Materials and Methods. The study presents a clinical case of one patient. At the diagnostic stage, model analysis, cephalometric analysis, and evaluation of OPG and CBCT data were performed.
Results. The clinical case demonstrates that in borderline skeletal Class III with a vertical growth pattern, excessive dentoalveolar compensation increases the risk of relapse. Third molars do not always cause crowding; however, in the presence of skeletal disharmony and periodontal risk, they may contribute to instability. Long-term stability depends on growth pattern, soft tissue pressure, periodontal status, and the selected retention protocol. Comprehensive diagnostics allow for a justified decision regarding third molar extraction and the use of TADs to control vertical parameters and the occlusal plane.
Conclusion. Underestimation of the skeletal component in patients with a vertical growth pattern is a significant factor in relapse. Eruption of third molars may further reduce post-retention stability, particularly in patients with a thin periodontal biotype. Long-term outcomes depend on an appropriate retention protocol and an interdisciplinary approach. The choice between orthodontic camouflage and surgical treatment should be based on extended diagnostics.
Keywords: orthodontic relapse, skeletal Class III, vertical growth pattern, third molars, TADs, periodontal risk.
