Orthodontic treatment associated with orthognathic surgery for the correction of class III malocclusion: case report

Abstract

To describe a clinical case of an orthodontic treatment associated with orthognathic surgery to correct a skeletal Class III malocclusion with facial asymmetry and crossbite. Patient E.M.R., 20 years old, male, with Class III malocclusion associated with crossbite and facial asymmetry, started orthodontic treatment with a Roth prescription fixed appliance. Tooth alignment and leveling and space closure were performed. Pre-surgical orthodontic treatment lasted 12 months. After orthodontic preparation, the patient underwent orthognathic surgery for 5 mm maxillary advancement with 4 degree clockwise rotation and segmentation with 7 mm increase in the distance between molars and 6mm mandibular setback with yaw correction, 4 degree clockwise rotation, followed by 4 mm advancement chinoplasty. The patient made use of intermaxillary elastics immediately after surgery. After 60 days, he was taken for orthodontic finishing with elastics for intercuspation of canines, removal of the appliance and installation of a 3x3 lower fixed retainer and upper removable retainer with a 1 mm acetate plate. Orthodontic treatment alone is not able to resolve skeletal discrepancies. With the help of orthognathic surgeries, the correction of malocclusions can occur in a more satisfactory and stable way, thus providing better aesthetics and quality of life for patients. Orthodontic preparations for orthognathic surgeries are increasingly present in the daily lives of orthodontists, for this, it is important to pay attention to the correct diagnosis and surgical planning, that good results can be achieved.