How to Correct Skeletal Class III Malocclusion

“Underbite” (also known as “reverse overjet”) refers to a condition where the lower jaw protrudes beyond the upper jaw, resulting in an aesthetically unpleasing facial profile. Orthodontic correction is typically required to improve this condition. However, severe underbites are often caused by skeletal discrepancies and necessitate surgical intervention. Such procedures fall under the category of minor cosmetic surgeries within aesthetic medicine; recovery generally takes about one week. Postoperative attention to diet and daily routines can accelerate wound healing. Below, we address the question: How is skeletal underbite corrected?

How Is Skeletal Underbite Corrected?

For mild mandibular prognathism, adjusting tooth angulation may resolve the protrusion. In contrast, severe skeletal mandibular prognathism requires combined orthodontic and orthognathic surgical treatment. This entails pre-surgical orthodontics—performed according to orthognathic requirements—to align teeth for optimal occlusion post-surgery. Following this preparatory phase, orthognathic surgery repositions the protruding mandible into its correct anatomical location. Postoperative orthodontics may also be necessary to fine-tune occlusion and alignment.

Additional Information: Key Considerations for Underbite Management

1. Maintain Excellent Oral Hygiene

Patients with underbite must diligently maintain oral hygiene. Daily brushing is essential to preserve oral health. Prior to any surgical or orthodontic procedure, patients may require professional dental cleaning (scaling) if oral hygiene is inadequate. Consistent oral hygiene helps suppress bacterial growth and prevents secondary inflammatory conditions such as gingivitis or periodontitis—thereby creating optimal conditions for successful underbite treatment.

2. Limit Snack Consumption

Patients—especially those undergoing orthodontic treatment—should significantly reduce intake of snacks and sweets. Frequent chewing of gum during treatment may compromise orthodontic outcomes and irritate orthodontic appliances. The sugar content in gum can also exert adverse effects on orthodontic materials; therefore, gum consumption should be minimized.

3. Avoid Bone-In or Hard-Shelled Foods

This precaution applies particularly during active orthodontic treatment. Patients should carefully select soft foods and strictly avoid bone-in meats, nuts, hard candies, or other hard-shelled items, as these may damage teeth or dislodge orthodontic appliances. Both orthodontic and orthognathic treatments involve placement of specialized devices (e.g., brackets, wires, or fixation hardware); consuming excessively hard foods risks fracturing or deforming these components.

The above outlines the approaches to correcting skeletal underbite. We hope this information proves helpful to you.