Combined Orthodontic and Surgical Approach in the Correction of a Class III Skeletal Malocclusion with Mandibular Prognathism and Vertical Maxillary Excess Using Bimaxillary Osteotomy

Abstract

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment. Surgery is not a substitute for orthodontics in these patients. Instead, it must be properly coordinated with orthodontics and other dental treatments to achieve good overall results. Dramatic progress in recent years has made it possible for combined surgical orthodontic treatment to be carried out successfully for patients with a severe dentofacial problem of any type. This case report provides an overview of the current treatment methodology in managing a combination of asymmetrical mandibular prognathism and vertical maxillary excess.

Ortho-Surgical Management of Open Bite Skeletal Class III Malocclusions with Periodontics Deficiency in Adult Patient: Case Report

“…Referring to Eckhardt & Cherackal [1,20] bimaxillary osteotomy, comparing to one-jaw osteotomies, offers a greater potential to modify anterior face height, what is heard on the soft tissues. This is why it's justified in patients, such as in this case, in the aim to improve excessive vertical dimension of the lower face [1,20].…”

“…Referring to Eckhardt & Cherackal [1,20] bimaxillary osteotomy, comparing to one-jaw osteotomies, offers a greater potential to modify anterior face height, what is heard on the soft tissues. This is why it's justified in patients, such as in this case, in the aim to improve excessive vertical dimension of the lower face [1,20]. Clinical success after orthognathic therapy can be defined as a combination of following factors: patient (and patient's family) satisfaction, Correct static and functional occlusion, patient comfort when chewing no pain in the temporomandibular joint and stability of the result in long term [16].…”

“…Prevalence of this type of malocclusion is different from a population to another, it goes in Caucasians ranges from 0.8 to 4.0%, to rises up to 12.13% in Japanese and Chinese populations, whatever in North Indian population, and it's found in up to 3.4% of the population [1]. Multi factorial causes are incremented in adult and include genetic and/or environmental factors.…”

Effect of Mandibular Set-Back surgery versus Bimaxillary Orthognathic Surgery on pharyngeal airway space and consequent daytime sleepiness in Dento-skeletal class III malocclusion patients.

“…The selected patients were divided equally into two groups, 12 patients each; Group A patients underwent mandibular set-back surgery in the form of bilateral sagittal split osteotomy (BSSO) surgery, while group B patients had Bimaxillary orthognathic surgery in the form of le fort I maxillary advancement with mandibular set-back BSSO surgery utilizing typical documented methodology (18,19) . (Fig.…”

Surgical correction of vertical maxillary excess associated with mandibular self-rotation

“…The orthognathic surgery is a procedure that aims at improvement of masticatory function, esthetic harmony and structural balance [1,3,4]. The first Le Fort I osteotomy for correction of malocclusion was introduced by Wassmund in 1927.…”