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Surgical Orthodontic Treatment for a Skeletal Class III and Asymmetric Patient: Case Report

Received: 20 February 2017     Accepted: 11 March 2017     Published: 23 October 2017
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Abstract

The aim of this article is to describe the treatment of a skeletal Class III and asymmetric patient. Two treatment alternatives were explained: -conventional orthodontics to camouflage the skeletal anomaly and -traditional orthodontics/orthognathic surgery approach; the surgical option was selected. Pre-surgical orthodontics was applied for leveling, aligning and relieving dental compensations. A Bilateral Sagital Split Osteotomy was performed for mandibular setback. Post-surgical orthodontics was applied for finishing and detailing occlusion. Total treatment time was 10 months. Facial balance was enhanced and a good dental occlusion was achieved. Careful treatment planning by the ortho-surgical team, proper application of biomechanics and good selection of dental orthodontic materials, allow the orthodontist to delay less time in the pre and post-surgical stages in the traditional surgical orthodontic approach.

Published in International Journal of Clinical Oral and Maxillofacial Surgery (Volume 3, Issue 2)
DOI 10.11648/j.ijcoms.20170302.12
Page(s) 11-15
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Orthognathic Surgery, Pre-surgical Orthodontics, Post-Surgical Orthodontics, Skeletal Class III

References
[1] O'Brien K, Wright J, Conboy F, Appelbe P, Bearn D, Caldwell S, Harrison J, Hussain J, Lewis D, Littlewood S, Mandall N, Morris T, Murray A, Oskouei M, Rudge S, Sandler J, Thiruvenkatachari B, Walsh T, Turbill E. Prospective, multi-center study of the effectiveness of orthodontic/orthognathic surgery care in the United Kingdom. Am J Orthod Dentofacial Orthop. 2009 Jun; 135 (6): 709-14. doi: 10.1016/j.ajodo.2007.10.043.
[2] Luther F, Morris DO, Hart C. Orthodontic preparation for orthognathic surgery: how long does it take and why? A retrospective study. Br J Oral Maxillofac Surg. 2003 Dec; 41 (6): 401-6.
[3] Rustemeyer J, Gregersen J. Quality of Life in orthognathic surgery patients: post-surgical improvements in aesthetics and self-confidence. J Craniomaxillofac Surg. 2012 Jul; 40 (5): 400-4. doi: 10.1016/j.jcms.2011.07.009. E pub 2011 Aug 23.
[4] Brachvogel P, Berten JL, Hausamen JE. [Surgery before orthodontic treatment: a concept for timing the combined therapy of skeletal dysgnathias]. Dtsch Zahn Mund Kieferheilkd Zentralbl. 1991; 79 (7): 557-563.
[5] Nagasaka H, Sugawara J, Kawamura H, Nanda R. "Surgery first" skeletal Class III correction using the Skeletal Anchorage System. J Clin Orthod. 2009 Feb; 43 (2): 97-105.
[6] Sugawara J, Aymach Z, Nagasaka DH, Kawamura H, Nanda R. "Surgery first" orthognathics to correct a skeletal class II malocclusion with an impinging bite. J Clin Orthod. 2010 Jul; 44 (7): 429-38.
[7] Yu CC, Chen PH, Liou EJ, Huang CS, Chen YR. A Surgery-first approach in surgical-orthodontic treatment of mandibular prognathism--a case report. Chang Gung Med J. 2010 Nov-Dec; 33 (6): 699-705.
[8] Villegas C, Uribe F, Sugawara J, Nanda R. Expedited correction of significant dentofacial asymmetry using a "surgery first" approach. J Clin Orthod. 2010 Feb; 44 (2): 97-103.
[9] Hernández-Alfaro F, Guijarro-Martínez R, Peiró-Guijarro MA. Surgery first in orthognathic surgery: what have we learned? A comprehensive workflow based on 45 consecutive cases. J Oral Maxillofac Surg. 2014 Feb; 72 (2): 376-90. doi: 1016/j.joms.2013.08.013. E pub 2013 Oct 16.
[10] Aristizábal JF, Martínez Smit R, Villegas C. The "surgery first" approach with passive self-ligating brackets for expedited treatment of skeletal Class III malocclusion. J Clin Orthod. 2015 Jun; 49 (6): 361-70.
[11] Vipul Kumar Sharma, Kirti Yadav, and Pradeep Tandon. An overview of surgery-first approach: Recent advances in orthognathic surgery. J Orthod Sci. 2015 Jan-Mar; 4 (1): 9–12. doi: 10.4103/2278-0203.149609.
[12] Liou EJ, Chen PH, Wang YC, Yu CC, Huang CS, Chen YR. Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery. J Oral Maxillofac Surg. 2011 Mar; 69 (3): 771-80. doi: 10.1016/j.joms.2010.11.011. E pub 2011 Jan 22.
[13] Jeong Hwan Kim, Niloufar Nouri Mahdavie and Carla A. Evans (2012). Guidelines for “Surgery First” Orthodontic Treatment, Orthodontics - Basic Aspects and Clinical Considerations, Prof. Farid Bourzgui (Ed.), ISBN: 978-953-51-0143-7, InTech, Available from http://www.intechopen.com/books/orthodontics-basicaspects-and-clinical considerations/orthodontic-guidelines-for-the-surgery-first-treatment-of-severe-maloclussions.
Cite This Article
  • APA Style

    Montesinos Armando F., Popnikolov Paulina, Ramirez Raymundo. (2017). Surgical Orthodontic Treatment for a Skeletal Class III and Asymmetric Patient: Case Report. International Journal of Clinical Oral and Maxillofacial Surgery, 3(2), 11-15. https://doi.org/10.11648/j.ijcoms.20170302.12

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    ACS Style

    Montesinos Armando F.; Popnikolov Paulina; Ramirez Raymundo. Surgical Orthodontic Treatment for a Skeletal Class III and Asymmetric Patient: Case Report. Int. J. Clin. Oral Maxillofac. Surg. 2017, 3(2), 11-15. doi: 10.11648/j.ijcoms.20170302.12

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    AMA Style

    Montesinos Armando F., Popnikolov Paulina, Ramirez Raymundo. Surgical Orthodontic Treatment for a Skeletal Class III and Asymmetric Patient: Case Report. Int J Clin Oral Maxillofac Surg. 2017;3(2):11-15. doi: 10.11648/j.ijcoms.20170302.12

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  • @article{10.11648/j.ijcoms.20170302.12,
      author = {Montesinos Armando F. and Popnikolov Paulina and Ramirez Raymundo},
      title = {Surgical Orthodontic Treatment for a Skeletal Class III and Asymmetric Patient: Case Report},
      journal = {International Journal of Clinical Oral and Maxillofacial Surgery},
      volume = {3},
      number = {2},
      pages = {11-15},
      doi = {10.11648/j.ijcoms.20170302.12},
      url = {https://doi.org/10.11648/j.ijcoms.20170302.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcoms.20170302.12},
      abstract = {The aim of this article is to describe the treatment of a skeletal Class III and asymmetric patient. Two treatment alternatives were explained: -conventional orthodontics to camouflage the skeletal anomaly and -traditional orthodontics/orthognathic surgery approach; the surgical option was selected. Pre-surgical orthodontics was applied for leveling, aligning and relieving dental compensations. A Bilateral Sagital Split Osteotomy was performed for mandibular setback. Post-surgical orthodontics was applied for finishing and detailing occlusion. Total treatment time was 10 months. Facial balance was enhanced and a good dental occlusion was achieved. Careful treatment planning by the ortho-surgical team, proper application of biomechanics and good selection of dental orthodontic materials, allow the orthodontist to delay less time in the pre and post-surgical stages in the traditional surgical orthodontic approach.},
     year = {2017}
    }
    

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    T2  - International Journal of Clinical Oral and Maxillofacial Surgery
    JF  - International Journal of Clinical Oral and Maxillofacial Surgery
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    AB  - The aim of this article is to describe the treatment of a skeletal Class III and asymmetric patient. Two treatment alternatives were explained: -conventional orthodontics to camouflage the skeletal anomaly and -traditional orthodontics/orthognathic surgery approach; the surgical option was selected. Pre-surgical orthodontics was applied for leveling, aligning and relieving dental compensations. A Bilateral Sagital Split Osteotomy was performed for mandibular setback. Post-surgical orthodontics was applied for finishing and detailing occlusion. Total treatment time was 10 months. Facial balance was enhanced and a good dental occlusion was achieved. Careful treatment planning by the ortho-surgical team, proper application of biomechanics and good selection of dental orthodontic materials, allow the orthodontist to delay less time in the pre and post-surgical stages in the traditional surgical orthodontic approach.
    VL  - 3
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Author Information
  • Department of Orthodontics, Postgraduate Studies and Research Division, Odontology Faculty, National Autonomous University of Mexico, México City, México

  • Department of Orthodontics, Postgraduate Studies and Research Division, Odontology Faculty, National Autonomous University of Mexico, México City, México

  • Department of Maxillofacial Surgery, Postgraduate Studies and Research Division, Odontology Faculty, National Autonomous University of Mexico, México City, México

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