Orthodontics and maxillofacial surgery: an interdisciplinary team. Case Report

Abstract

Dentofacial anomalies cause disharmony in the maxilla and the mandible with consequences in facial esthetics and masticatory function. As surgeries and osteotomies became more complex the need for cooperation between the orthodontist and the maxillofacial surgeon became more evident. A case report of a 1 year and 8 months treatment time of an 18-year-old patient, with skeletal class III malocclusion, anterior crossbite and posterior unilateral crossbite, upper incisor proclination and lower incisor retroclination, and vertical growth is hereby presented. A treatment plan was set out with surgical-orthodontic treatment which is divided in three phases: First presurgical phase with 0.022 x 0.028 Roth system and arch sequence, second surgical phase performing a triple surgery: Le Fort I for maxillary advancement, with segmental surgery on the left side and vertical osteotomy of the mandibular ramus for mandible repositioning. A good facial harmony and improvement of the skeletal and dental relationship were obtained but most importantly, neuromuscular regulation improvement and stomatognathic function. Conclusion: The satisfactory results in combined orthodontic and orthognathic surgery treatments depend on a good diagnosis and treatment plan of the dentofacial deformity, as well as on good knowledge integration between the professionals involved in the case.Key words: Skeletal class III, orthodontics, maxillofacial surgery, orthognathic surgery.