Pseudo Class III Malocclusion

CCO Case File: Class III Non-Extraction/Female 13.6 yrs.

Author: Dr. Antonino Secchi

Before 1
Initial extraoral photos


Intraoral photos before treatment.
Intraoral photos before treatment.


Pre Tx

Case summary:
13:6 yo Female with a Pseudo Class III malocclusion. Her vertical as well as her transverse dimension were normal. It is important to notice the distal tip of her upper canines, the uneven maxillary occlusal plane and the spaces behind the canines in the lower arch.
Tx Strategy by Stages:
Stage I: Leveling and aligning, correct all rotations and obtain normal tipping of upper canines.
Stage II: Coordinate upper and lower arches, level maxillary occlusal plane, close lower spaces using Sentalloy coils and short Class III elastics. Normalize OJ/OB relationship.
Stage III: Achieve optimal intercuspation of the buccal segment using vertical triangular elastics.
In-Ovation ‘R’ CCO System
Wire Sequence:
Stage I: 0.014” Sentalloy AccuForm Medium.
0.020” x 0.020” Bioforce AccuForm Medium.
Stage II: 0.019” x 0.019” SS AccuForm Medium.
Stage III: 0.019” x 0.019” Braided AccuForm Medium.
Sentalloy Coils 150 gr.
Elastics 3/16” 6oz (Thailand).
Elastics 3/16” 8oz (Africa).

1AStage I. In-Ovation ‘R’ CCO System with upper and lower 0.014” Sentalloy AccuForm Medium wires. Patient is touching bis a bis in centric.

1BStage I. Upper and lower 0.020” x 0.020” Bioforce AccuForm Medium wires.

2AStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Wires must be coordinated before placement. Build ups on lower molars using blue compomer to open the bite. Short Class III elastics 3/16” 6oz are introduced at night time.

2BStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Notice how the upper archwire is now completely leveled. Lower Sentalloy coils (150 gr) and Class III elastics (night time), to close spaces.

2CStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Upper and lower occlusal planes leveled and paralleled. Finishing space closure. Power Chain is used to consolidate spaces. Vertical triangular elastics 3/16” 6oz.

2DStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Spaces are consolidated. Good OJ/OB. Continues with vertical triangular elastics 3/16” 6oz.

3AStage III. Upper 0.019” x 0.025” Braided AccuForm Medium wire and vertical triangular elastics 3/16” 6oz or 8 oz.

FinalIntraoral final photos. 17 months of active Tx.


Extraoral final photos.
Extraoral final photos.
Intraoral photos 1 year post Tx.
Intraoral photos 1 year post Tx.


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5 thoughts on “Pseudo Class III Malocclusion”

  1. Dr. Seechi,

    I noticed you didn’t use crimpable hooks on the lower wire during space closure. Did you just chain lower 3-3 at each appointment?



    1. Hi David,
      You are right, in this case I did power chain lower 3 to 3 at each appointment. I wanted to consolidate some spaces she developed 3 to 3 and start moving the segment back. I usually place a “T” hook on the wire and then I place the Sentalloy coils to the hook, but sometimes I am on the run…and I just place the Sentalloy coil to the canine hook and power chain 3 to 3. I have seen both ways to work well.

  2. Hello Dr. Antonino Secchi
    My name is Luis Sanchez orthodontic I am a student and I find very interesting your case with the CCO system copn If I could help the entire case for presentation in class thanks …

    1. Hello Luis,

      Your request has been forwarded to Dr. Secchi. We will send you a response within the next few days. Thank you for reaching out to us!

    2. Hi Luis,

      Thank you for your interest in this case! You can go to our website: and go to Clinical Support and then to Case Gallery. There, you will find this case and many others in a PDF format that you can download. Make sure you take a look at the entire website to find much more info about the CCO System!


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