EOS Annual Virtual Conference 2021, Hamburg, Germany, 2 - 03 July 2021, pp.23
TREATMENT OF A SEVERE SKELETAL CLASS III PATIENT COMBINED WITH ORTHODONTICS AND ORTHOGNATHIC SURGERY
AIM: Skeletal Class III malocclusion may be a result of excessive mandibular growth and/or deficient of the maxilla. Orthognathic surgery is the only possible treatment approach for some patients whose skeletal malocclusion is severe that neither growth modification nor camouflage offers a solution.The aim of this case report is to present the progress and results of orthodontic and orthognathic surgical treatment of a patient with a skeletal Class III malocclusion.
Material & Method: An 18 year-old male with a severe skeletal Class III malocclusion referred to our clinic with the complaint of an unattractive facial appearance. Doligofacial growth pattern, concave profile, maxillary transverse deficiency, skeletaly and dentally Class III malocclusion were determined. Overbite was 1 mm , overjet was -7 mm. Cephalometric analysis showed that SNA:77.5 ̊ , SNB:84.7 ̊ , ANB:-7,2 ̊ GO-GoMe:47.1 ̊, UI-SN:103 ̊, IMPA:61 ̊. The patient was prepared for the orthognathic surgery with fixed orthodontic treatment. After levelling and alignment, Class II elastics were given for the dental decompensation. IMPA:87 ̊ and overjet was -15 mm before surgery. Bimaxillary orthognatic surgery (8mm maxillary advancement and 3 mm anterior and 1 mm posterior impaction, 9 mm mandibular set-back) was planned with soft tissue profile prediction methods. Counter-clockwise rotation was done due to decrease the excessive facial height.
RESULTS: At the end of the treatment, satisfactory aesthetic profile, Class I molar and class I canine relationship, well-aligned dental arches, ideal overbite and overjet were obtained.
CONCLUSION: Collaboration of orthodontists and maxillofacial surgeons is the key factor in achieving favourable results in such cases. Combined orthodontic treatment and bimaxillary orthognatic surgery is an effective method to achieve the esthetics and functional treatment in adult patients with skeletal Class III malocclusion.