Combined prosthodontic and orthodontic treatment of a patient with a Class III skeletal malocclusion: a clinical report

2004 ◽  
Vol 92 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Olcay Sakar ◽  
Mehmet Beyli ◽  
Gulnaz Marsan
2021 ◽  
Vol 8 ◽  
Author(s):  
Laila Elhajoubi ◽  
Intissar Elidrissi ◽  
Asmae Bahoum ◽  
Fatima Zaoui ◽  
Mohammed Faouzi Azaroual

Introduction: This case report describes compensatory orthodontic treatment in a young patient aged 13 years. She presented with a class III skeletal malocclusion associated with mandibular laterognathy. The patient's main reason for consultation was the anterior cross bite and the aesthetics of her smile.Materials and Methods: The chosen treatment was therefore an orthodontic camouflage with the extraction of the first mandibular premolars and the second maxillary premolars, in order to catch a correct anterior articular and restore a good occlusal relationship, however, the mandibular laterognathy was camouflaged by means of dental compensations and also by correcting the deviation of the incisors medians through a class III mechanics with good anchorage management.Results: After 24 months of treatment, an ideal overjet and overbite associated with a Class I canine and molar relationship, was obtained, associated with a perfect coincidence of the interincisor medians.Conclusion: Class III skeletal cases can often be treated either by orthodontic camouflage or surgery. In our case study, the treatment adopted was orthodontic camouflage with extractions. The results of the treatment were satisfactory and the occlusal objectives were achieved. The final harmonious smile pleased the patient and improved her self-esteem and quality of life.


2013 ◽  
Vol 2013 ◽  
pp. 1-12
Author(s):  
George Jose Cherackal ◽  
Eapen Thomas ◽  
Akhilesh Prathap

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.


2016 ◽  
Vol 21 (6) ◽  
pp. 103-114 ◽  
Author(s):  
Marcelo Quiroga Souki

ABSTRACT The present case report describes the orthodontic treatment of a young adult patient (18y / 1m), Class III skeletal malocclusion, with mandibular prognathism and significant dental compensation. The canine relation was Class III, incisors with tendency to crossbite and open bite, moderate inferior crowding, and concave profile. Skeletal correction of malocclusion, facial profile harmony with satisfactory labial relationship, correction of tooth compensation and normal occlusal relationship were obtained with orthodontic treatment associated to orthognathic surgery. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requirements to become a BBO diplomate.


2020 ◽  
Vol 25 (2) ◽  
pp. 32-43
Author(s):  
Rhita Cristina Cunha Almeida ◽  
Livia Kelly Ferraz Nunes ◽  
Ingrid Balbino Sousa Coelho Vieira ◽  
Felipe de Assis Ribeiro Carvalho ◽  
Marco Antonio de Oliveira Almeida

ABSTRACT A healthy 15-year-old boy with anterior open bite, edge-to-edge transverse discrepancy, and Class III skeletal relationship sought a nonsurgical orthodontic treatment. The patient was treated with premolars extraction, a Hyrax expander and intrusion mechanics with vertical elastics. This mechanics allowed for excellent facial and occlusal results. The final occlusion presented Class I molar and canine relationships, ideal overjet and overbite, and straight facial profile. Analysis of the posttreatment and follow-up radiographs showed that the treatment outcomes remained stable seven years after active orthodontic treatment. Thus, although combined orthodontic and surgical treatment should be considered for patients with this skeletal malocclusion, this case report proves that well controlled orthodontic movement with the patient’s cooperation can be a valid alternative treatment, with good and stable outcomes for patients who refuse surgery.


2021 ◽  
Vol 32 (3) ◽  
pp. 164
Author(s):  
Endah Mardiati ◽  
Ida Ayu Astuti

Pendahuluan: Asimetri wajah akibat canting oklusal rahang atas seringkali menjadi keluhan  estetika wajah pasien. Perawatan canting oklusal parah memerlukan kombinasi perawatan ortodonti cekat dengan bedah ortognati. Tujuan laporan kasus ini adalah untuk menjelaskan perawatan ortodonti cekat kombinasi bedah Le Fort 1 pada kasus canting oklusal rahang atas pada maloklusi dentoskeletal kelas III disertai asimetri wajah. Laporan kasus: Seorang pasien perempuan umur 17 tahun 7 bulan datang ke praktek pribadi dengan keluhan gigi rahang atas miring, gigi belakang kanan tidak dapat mengunyah dengan nyaman. Pasien ingin dirawat gigi dan rahangnya. Pemeriksaan ekstra oral menunjukan wajah asimetri, profil cekung dan dagu sedikit menonjol. Pemeriksaan intra oral,  garis median rahang atas bergeser ke kiri, rahang bawah bergeser ke kanan, crossbite anterior, crossbite posterior unilateral, retrusi gigi anterior rahang atas dan rahang bawah. Analisis sefalometri lateral: maloklusi dentoskeletal kelas III. Diagnosis yang diberikan adalah maloklusi dentoskeletal kelas III disertai canting oklusal rahang atas, wajah asimetri, crossbite anterior, crossbite unilateral posterior. Rencana perawatan adalah perawatan ortodonti cekat kombinasi bedah ortognati Le Fort 1. Perawatan dilakukan dalam 4 tahap yaitu perawatan ortodonti dekompensasi, perawatan bedah ortognati rahang atas, perawatan ortodonti pasca bedah rahang, debonding dan pemasangan retainer. Simpulan: Maloklusi skeletal kelas III disertai canting oklusal rahang atas, asimetri wajah, crossbite anterior, dan crossbite posterior unilateral, yang dirawat menggunakan alat ortodonti cekat dan bedah ortognati Le Fort 1 dapat berhasil dengan baik. Relasi dental dan skeletal tercapai kelas I, interdigitasi gigi rahang atas dan rahang bawah mengunci, fungsi pengunyahan terkoreksi serta pasien merasa sangat puas dengan estetika wajahnya.Kata kunci: Maloklusi skeletal kelas III, asimetri wajah, canting maksila, crossbite anterior, crossbite posterior unilateral, bedah ortognati. ABSTRACTIntroduction: Facial asymmetry due to maxillary occlusal cant often becomes a facial aesthetics complaint. Treatment of severe occlusal cant requires a combination of fixed orthodontic treatment with orthognathic surgery. This case report was aimed to describe the combined fixed orthodontic treatment of Le Fort 1 in maxillary occlusal cant of class III dentoskeletal malocclusion with facial asymmetry. Case report: A female patient aged 17 years seven months came to the private clinic, complained of oblique maxillary teeth, and the right posterior was unable to masticate comfortably. The patient wants to be treated for her teeth and jaw. Extraoral examination revealed facial asymmetry, sunken profile and slightly protruding chin. The intraoral examination resulted in the maxillary median line that shifted to the left, mandible shifted to the right, anterior crossbite, unilateral posterior crossbite, and retrusion of maxillary and mandibular anterior teeth. The lateral cephalometric analysis resulted in class III dentoskeletal malocclusion. The diagnosis was class III dentoskeletal malocclusion with maxillary occlusal cant, facial asymmetry, anterior crossbite, and posterior unilateral crossbite. The treatment plan was fixed orthodontic treatment combined with Le Fort orthognathic surgery. The treatment was carried out in 4 stages: decompensated orthodontic treatment, maxillary orthodontic treatment, post-orthognathic surgery orthodontic treatment, debonding, and retainer placement. Conclusion: Class III skeletal malocclusion with maxillary occlusal cant, facial asymmetry, anterior crossbite, and the unilateral posterior crossbite was successfully treated with a fixed orthodontic appliance and Le Fort 1 orthognathic surgery. The dental and skeletal relations were achieved for class I, the interdigitation of the maxillary and mandibular teeth was locked, the masticatory function was corrected, and the patient was very satisfied with her facial aesthetics.Keywords: Class III skeletal malocclusion, facial asymmetry, maxillary cant, anterior crossbite, unilateral posterior crossbite, orthognathic surgery.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Farzad Rezaei ◽  
Hiwa Masalehi ◽  
Amin Golshah ◽  
Mohammad Moslem Imani

Abstract Background Orthognathic surgery includes improvement of morphology and function of occlusion as well as psychological perception and oral health-related quality of life (OHRQoL) of patients. The aim of this study was to determine the OHRQoL of patients with class III skeletal malocclusion before and after orthognathic surgery. Materials and methods A total of 112 skeletal class III patients including 39 (34.8%) males and 73 (65.2%) females participated in this descriptive quasi-experimental study in three groups: “prior to orthodontic treatment” (n = 25); “under orthodontic treatment and prior to surgery” (n = 65), and “after surgery” (n = 25). All patients filled out a demographic information questionnaire, the oral health impact profile-14 (OHIP-14), and the orthognathic quality of life questionnaire (OQLQ) under the supervision of the examiner. Data were analyzed using ANOVA, independent samples t-test, Mann Whitney test, and Kruskal-Wallis test. Results OHRQoL summary score changed from 14.5 prior to orthodontic treatment to 23.4 prior to surgery and during orthodontic treatment to 5.4 after surgery. These OHRQoL changes were statistically significant (P < 0.001). Conclusions Orthognathic surgery matters to patients with class III skeletal malocclusion and significantly improves their OHRQoL.


Author(s):  
Sarwat Memon

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.


2021 ◽  
Vol 11 (14) ◽  
pp. 6439
Author(s):  
Ewa Zawiślak ◽  
Szymon Przywitowski ◽  
Anna Olejnik ◽  
Hanna Gerber ◽  
Paweł Golusiński ◽  
...  

The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.


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