Rhinoplasty, septoplasty and genioplasty with fixed orthodontic mechanotherapy for non-surgical correction of a patient with “Long face syndrome” Having a class III malocclusion on a class II skeletal jaw base - A case report

Abstract

This case report emphasizes on the management of a male patient having a Long Face Syndrome and a unique malocclusion with a Class III dental malocclusion over a Class II Skeletal Base. This patient showed the presence of an increased lower anterior facial height with the chin deviated slightly towards the left. The patient also complained of difficulty in breathing and presented with a history of Deviated Nasal septum and Nasal Polyps. This case was corrected non surgically merely by employing simple mechanics with the help of Fixed Orthodontic Mechanotherapy by extracting both the mandibular 1 premolars followed by retraction and closure of spaces. After Orthodontic treatment was completed, a Septoplasty was performed to correct the deviated nasal septum and the nasal polyp was excised thus addressing the difficulty in breathing experienced by the patient. Both Septoplasty and Polyp removal were performed using Non Invasive FESS (Functional Endoscopic Sinus Surgery). This was followed by Rhinoplasty for correction of nasal contour of the patient. Lastly, 2 types of Genioplasties were performed to correct the backwardly positioned chin, to reduce the vertical height of the chin and also to correct the deviated chin position. Following fixed orthodontic treatment and minor surgical procedures, marked improvement in patient's smile, facial profile and lip competence were achieved and there was a remarkable increase in the patient's confidence and quality of life The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with fixed appliance therapy. The Long Face of the patient was corrected merely by minor elective surgical procedures, thus eliminating the need for a major surgery. Total treatment duration was 18 months.