Surgical-orthodontic treatment of a class III patient with asymmetry due to mandibular deviation. Case report

Abstract

Case report: Craniofacial asymmetries are expressed as differences in size or relationship between two parts of face. Treatment for dental asymmetries is orthodontic, whether through occlusal adjustments, splints or fi xed appliances. In skeletal asymmetries surgery is necessary, especially in cases where growth has ceased. The aim of orthodontic-surgical treatment is to achieve cranio-facial harmony. Treatment planning should consider: etiology, severity, disorder’s location, age and patient motivation. In this article we present the case report of a 21-year-old patient with skeletal class III maloclussion, molar class III in both sides and left canine class III relationship; canine class on the right side was non-assessable, anterior crossbite, upper incisor retroclination and low incisor proclination; left laterognathia and vertical growth. The treatment was orthodontic-surgical in three phases: orthodontic pre-surgical phase with 0.022" Roth appliances; the surgical phase included mandibular setback with the sagittal ramus osteotomy technique and laterognatia correction and an orthodontic post-surgical phase where dental- skeletal Class I, good facial harmony and a straight profi le were obtained. Conclusion: Communication between the orthodontist and the oral surgeon is essential to achieve treatment goals as well as the expertise of the professionals involved in the treatment.