Abstract :
Skeletal Class III malocclusion usually presents with deficient maxilla, mandibular prognathism or both compromising function and facial esthetics. It is generally corrected in conjunction with orthodontic treatment and orthognathic surgical procedure to harmonize facial profile and to improve the facial esthetics. Development of a surgical visual treatment objective (VTO) and a detailed analysis of pre- treatment investigation are necessary to plan the type of surgical technique required. A 19-year-old male patient with relapse, moderate skeletal Class III malocclusion and concave profile was referred to our department. Skeletally, he presented with mandibular excess and posteriorly placed maxilla along with a hypodivergent growth pattern. Dentally, Class III molar and canine relationship, reverse overjet and anterior crossbite with proclined upper (U1-SN: 1220 ) and lower incisors (L1-MP: 970 ). Maxillary advancement was planned in order to correct the mid-face deficiency, and mandibular setback to improve the concave profile and correct the mandibular excess. The decompensation phase involved closure of all the anterior spaces and retraction of the upper teeth. Lower spaces were closed and the incisors were proclined. Negative overjet was created (- 6mm). Bi-jaw surgery which included a Le-fort I osteotomy for maxillary advancement (3mm), bilateral sagittal split osteotomy (BSSO) for mandibular setback (5mm) was done to correct the dental and skeletal Class III This case report describes a multidisciplinary approach in the successful management of a relapsed case with posteriorly positioned maxilla and mandibular skeletal excess to achieve superior function, stability, facial esthetics and an ideal occlusion.
Keyword :
Orthognathic surgery, skeletal Class III, Le-Fort I, BSSO, late mandibular growth.