Orthodontic-surgical correction of a class III malocclusion through a surgery-first protocol: case report

Abstract

Dentomaxillofacial deformities are conditions that lead to a disharmony between the maxilla and mandible seriously affecting facial appearance and masticatory function. Sometimes the orthodontist requires the collaboration of a maxillofacial surgeon specially. Ever since interventions and osteotomies became more complex an interdisciplinary relationship was established between both specialties. This case report presents a 13-year-old patient with a skeletal class III accompanied by maxillary hypoplasia and mandibular anterior displacement causing an anterior and posterior crossbite. Presurgical orthodontics was performed with 0.022” slot Roth appliances. Once the arches were coordinated, the patient was refered for a surgicalassessment. Orthognathic surgery was performed: a LeFort Imaxillary advancement with a mandibular ramus segmental surgerywas performed to reposition the jaw and treatment was finished with orthodontics to settle the bite. An occlusal adjustment was performed for obtaining the right mandibular movements and appliances were removed having achieved the desired objectives. It is important to make a proper diagnosis to define treatment objectives for each patient in order to improve aesthetics and function.