scholarly journals Orthodontic-surgical treatment of class III malocclusion with mandibular asymmetry

2011 ◽  
Vol 22 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Ana Zilda Nazar Bergamo ◽  
Marcela Cristina Damião Andrucioli ◽  
Fábio Lourenço Romano ◽  
José Tarcísio Lima Ferreira ◽  
Mírian Aiko Nakane Matsumoto
Keyword(s):  
Orthognathic Surgery ◽  
Facial Asymmetry ◽  
Open Bite ◽  
Class Iii ◽  
Posterior Crossbite ◽  
Mandibular Asymmetry ◽  
Skeletal Malocclusion ◽  
Facial Esthetics ◽  
The Face ◽  
Maxillary Deficiency

Class III skeletal malocclusion may present several etiologies, among which maxillary deficiency is the most frequent. Bone discrepancy may have an unfavorable impact on esthetics, which is frequently aggravated by the presence of accentuated facial asymmetries. This type of malocclusion is usually treated with association of Orthodontics and orthognathic surgery for correction of occlusion and facial esthetics. This report presents the treatment of a patient aged 15 years and 1 month with Class III skeletal malocclusion, having narrow maxilla, posterior open bite on the left side, anterior crossbite and unilateral posterior crossbite, accentuated negative dentoalveolar discrepancy in the maxillary arch, and maxillary and mandibular midline shift. Clinical examination also revealed maxillary hypoplasia, increased lower one third of the face, concave bone and facial profiles and facial asymmetry with mandibular deviation to the left side. The treatment was performed in three phases: presurgical orthodontic preparation, orthognathic surgery and orthodontic finishing. In reviewing the patient's final records, the major goals set at the beginning of treatment were successfully achieved, providing the patient with adequate masticatory function and pleasant facial esthetics.

scholarly journals Class III malocclusion with severe anteroposterior discrepancy

2012 ◽  
Vol 17 (5) ◽  
pp. 178-189 ◽  
Author(s):  
Susana Maria Deon Rizzatto
Keyword(s):  
Orthognathic Surgery ◽  
Clinical Case ◽  
Post Treatment ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Mandibular Prognathism ◽  
Skeletal Malocclusion ◽  
Facial Esthetics ◽  
Maxillary Deficiency ◽  
Lower Arch

This study aims at reporting the clinical case of a patient with Class III skeletal malocclusion with severe maxillary deficiency, producing a reduced midface associated with severe mandibular prognathism. The pre-surgical orthodontic preparation was composed mainly by dentoalveolar expansion and repositioning of the incisors in the lower arch. Then, a combined maxillary and mandibular orthognathic surgery was performed. The treatment objectives were achieved, with significant improvement in facial esthetics and occlusion, followed by post-treatment stability. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requirements for obtaining the title of Diplomate by BBO.

scholarly journals Perawatan bedah ortognati pada maloklusi dentoskeletal kelas III dengan asimetri wajah dan canting oklusal rahang atasOrthognathic surgical treatment of class III dentoskeletal malocclusion with facial asymmetry and maxillary occlusal cant

2021 ◽  
Vol 32 (3) ◽  
pp. 164
Author(s):  
Endah Mardiati ◽  
Ida Ayu Astuti
Keyword(s):  
Case Report ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Facial Asymmetry ◽  
Class Iii ◽  
Le Fort ◽  
Posterior Crossbite ◽  
Skeletal Malocclusion ◽  
Anterior Teeth ◽  
The Right

Pendahuluan: Asimetri wajah akibat canting oklusal rahang atas seringkali menjadi keluhan  estetika wajah pasien. Perawatan canting oklusal parah memerlukan kombinasi perawatan ortodonti cekat dengan bedah ortognati. Tujuan laporan kasus ini adalah untuk menjelaskan perawatan ortodonti cekat kombinasi bedah Le Fort 1 pada kasus canting oklusal rahang atas pada maloklusi dentoskeletal kelas III disertai asimetri wajah. Laporan kasus: Seorang pasien perempuan umur 17 tahun 7 bulan datang ke praktek pribadi dengan keluhan gigi rahang atas miring, gigi belakang kanan tidak dapat mengunyah dengan nyaman. Pasien ingin dirawat gigi dan rahangnya. Pemeriksaan ekstra oral menunjukan wajah asimetri, profil cekung dan dagu sedikit menonjol. Pemeriksaan intra oral,  garis median rahang atas bergeser ke kiri, rahang bawah bergeser ke kanan, crossbite anterior, crossbite posterior unilateral, retrusi gigi anterior rahang atas dan rahang bawah. Analisis sefalometri lateral: maloklusi dentoskeletal kelas III. Diagnosis yang diberikan adalah maloklusi dentoskeletal kelas III disertai canting oklusal rahang atas, wajah asimetri, crossbite anterior, crossbite unilateral posterior. Rencana perawatan adalah perawatan ortodonti cekat kombinasi bedah ortognati Le Fort 1. Perawatan dilakukan dalam 4 tahap yaitu perawatan ortodonti dekompensasi, perawatan bedah ortognati rahang atas, perawatan ortodonti pasca bedah rahang, debonding dan pemasangan retainer. Simpulan: Maloklusi skeletal kelas III disertai canting oklusal rahang atas, asimetri wajah, crossbite anterior, dan crossbite posterior unilateral, yang dirawat menggunakan alat ortodonti cekat dan bedah ortognati Le Fort 1 dapat berhasil dengan baik. Relasi dental dan skeletal tercapai kelas I, interdigitasi gigi rahang atas dan rahang bawah mengunci, fungsi pengunyahan terkoreksi serta pasien merasa sangat puas dengan estetika wajahnya.Kata kunci: Maloklusi skeletal kelas III, asimetri wajah, canting maksila, crossbite anterior, crossbite posterior unilateral, bedah ortognati. ABSTRACTIntroduction: Facial asymmetry due to maxillary occlusal cant often becomes a facial aesthetics complaint. Treatment of severe occlusal cant requires a combination of fixed orthodontic treatment with orthognathic surgery. This case report was aimed to describe the combined fixed orthodontic treatment of Le Fort 1 in maxillary occlusal cant of class III dentoskeletal malocclusion with facial asymmetry. Case report: A female patient aged 17 years seven months came to the private clinic, complained of oblique maxillary teeth, and the right posterior was unable to masticate comfortably. The patient wants to be treated for her teeth and jaw. Extraoral examination revealed facial asymmetry, sunken profile and slightly protruding chin. The intraoral examination resulted in the maxillary median line that shifted to the left, mandible shifted to the right, anterior crossbite, unilateral posterior crossbite, and retrusion of maxillary and mandibular anterior teeth. The lateral cephalometric analysis resulted in class III dentoskeletal malocclusion. The diagnosis was class III dentoskeletal malocclusion with maxillary occlusal cant, facial asymmetry, anterior crossbite, and posterior unilateral crossbite. The treatment plan was fixed orthodontic treatment combined with Le Fort orthognathic surgery. The treatment was carried out in 4 stages: decompensated orthodontic treatment, maxillary orthodontic treatment, post-orthognathic surgery orthodontic treatment, debonding, and retainer placement. Conclusion: Class III skeletal malocclusion with maxillary occlusal cant, facial asymmetry, anterior crossbite, and the unilateral posterior crossbite was successfully treated with a fixed orthodontic appliance and Le Fort 1 orthognathic surgery. The dental and skeletal relations were achieved for class I, the interdigitation of the maxillary and mandibular teeth was locked, the masticatory function was corrected, and the patient was very satisfied with her facial aesthetics.Keywords: Class III skeletal malocclusion, facial asymmetry, maxillary cant, anterior crossbite, unilateral posterior crossbite, orthognathic surgery.

scholarly journals Correction of transverse maxillary deficiency and anterior open bite in an adult Class III skeletal patient

2016 ◽  
Vol 6 ◽  
pp. 166-170
Author(s):  
Prerna Hoogan Teja ◽  
Samarjit Singh Teja ◽  
Rabindra S. Nayak ◽  
Abhijit Bagade ◽  
Manu Rashmi Sharma
Keyword(s):  
Transverse Dimension ◽  
Open Bite ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Anterior Open Bite ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Rapid Palatal Expansion ◽  
Dental Crowding ◽  
Maxillary Deficiency

Transverse maxillary deficiency may be associated with sagittal or vertical problems of the maxilla or mandible. It may contribute to unilateral or bilateral posterior crossbite, anterior dental crowding, and unesthetic black buccal corridors on smiling. An adequate transverse dimension is important for stable and proper functional occlusion. Surgically, assisted rapid palatal expansion has been the treatment of choice to resolve posterior crossbite in skeletally mature patients. The following case report presents an adult Class III skeletal patient with an anterior open bite and bilateral posterior crossbite which was treated by surgically assisted rapid maxillary expansion with satisfactory outcomes.

scholarly journals “Orthognathic Surgery to Improve the Facial Profile: Technique, 3D Planning and Assessment”

2020 ◽  
Author(s):  
Kitae E Park ◽  
Seija Maniskas ◽  
Omar Allam ◽  
Navid Pourtaheri ◽  
Derek M Steinbacher
Keyword(s):  
Orthognathic Surgery ◽  
Skeletal Maturity ◽  
Fat Grafting ◽  
Open Bite ◽  
Class Iii ◽  
Maxillary Hypoplasia ◽  
Delayed Treatment ◽  
3 Dimensional ◽  
Mandibular Asymmetry ◽  
Facial Harmony

Abstract A concave profile with class III malocclusion is most often due to a combination of maxillary hypoplasia and mandibular hyperplasia. Surgical correction entails normalization of jaw positions and is more challenging in the setting of concurrent asymmetry and open bite. Treatment should optimize both facial harmony and occlusion. Orthognathic surgery for class III deformities occurs at skeletal maturity and should address all aspects of the condition while preventing unnecessary emotional stress from delayed treatment. In this article, the authors describe the 3-jaw orthognathic surgery technique to address maxillary hypoplasia, mandibular prognathism, open bite and mandibular asymmetry in a single procedure. The process of preoperative 3-dimensional virtual surgical planning, detailed surgical technique, fat grafting, and a comparison of pre and postoperative 3D aesthetic outcome is presented. Additionally, a retrospective review of postoperative outcomes of 54 patients who received 3-jaw orthognathic surgery is presented as well.

scholarly journals Periodontally compromised severe skeletal Class III with open bite corrected by orthodontic camouflage using temporary anchorage devices

2020 ◽  
Vol 10 ◽  
pp. 253-258
Author(s):  
Adith Venugopal ◽  
M. Srirengalakshmi ◽  
Anand Marya ◽  
Paolo Manzano
Keyword(s):  
Orthognathic Surgery ◽  
Treatment Options ◽  
Open Bite ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Anterior Open Bite ◽  
Skeletal Class ◽  
Temporary Anchorage Devices ◽  
Anterior Teeth ◽  
Facial Esthetics

A variety of treatment options may be implemented on a Class III malocclusion associated with skeletal discrepancy ranging from functional orthopedics at an early age to orthognathic surgery in adults. In the current scenario, many Class III malocclusion patients are referred for orthognathic surgery without even considering the options of an orthodontic camouflage, as orthodontists do not want to burden themselves with the tedious treatment planning and risks involved with treating such cases. This case report describes a 27-year-old female diagnosed with a skeletal Class III malocclusion, severe open bite, and periodontally compromised dentition. Although orthognathic surgery was proposed as the best treatment modality, it was denied by the patient due to financial and psychological constraints. She was treated with mild upper arch expansion using archwires and upper premolar intrusion using temporary anchorage devices (TADs) alongside retraction of lower anterior teeth using TADs and intermaxillary elastics. At the end of 18 months of active treatment, a decent result was achieved with good occlusion and facial esthetics. Post-treatment results showed an improved profile and Class I canine relationships, with optimal overjet and overbite. The anterior open bite was corrected, and the overall facial balance was greatly improved. Extraoral photographs displayed a relaxed lip closure and an esthetic smile meeting the patient’s expectations. Two-year follow-up records demonstrated a stable occlusion and optimal facial esthetics.

scholarly journals Orthosurgical management of an asymmetric case with class III malocclusion and transversal problem in the maxilla

2016 ◽  
Vol 6 ◽  
pp. 160-165 ◽  
Author(s):  
Juan Carlos Pérez Varela ◽  
Beatriz Iglesias Sánchez
Keyword(s):  
Case Report ◽  
Male Patient ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Skeletal Class ◽  
Mandibular Asymmetry ◽  
Facial Esthetics ◽  
Asymmetric Case ◽  
The Face ◽  
Adult Male Patient

Class III malocclusions are considered to be one of the most difficult problems to treat. For us, the complex of these cases is the esthetic of the face and the smile because the treatment of the malocclusions without surgery produces a more retrusive face. We present a case report of an adult male patient with skeletal Class III malocclusion with compression in the maxilla and mandibular asymmetry, who has treated the orthosurgical approach. The result is acceptable in terms of occlusion-function, esthetic of the smile, and facial esthetics.

scholarly journals Skeletal Class III Malocclusion with Lateral Open Bite and Facial Asymmetry Treated with Asymmetric Lower Molar Extraction and Lingual Appliance: A Case Report

2021 ◽  
Vol 18 (10) ◽  
pp. 5381
Author(s):  
Vo Truong Nhu Ngoc ◽  
Nguyen Thi Thu Phuong ◽  
Nguyen Viet Anh
Keyword(s):  
Case Report ◽  
Open Bite ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Skeletal Class ◽  
Facial Esthetics ◽  
Lingual Appliance ◽  
Lower Incisors ◽  
Mandibular Incisors ◽  
Molar Extraction

A skeletal Class III malocclusion with open bite tendency is considered very difficult to treat orthodontically without surgery. This case report describes the lingual orthodontic treatment of an adult skeletal Class III patient with mandibular deviation to the left side, lateral open bite, unilateral posterior crossbite, zero overbite and negative overjet. The lower incisors were already retroclined to compensate with the skeletal discrepancy. The patient was treated by asymmetric molar extraction in the mandibular arch to retract the lower incisors and correct the dental midline, with the help of intermaxillary elastics. Lingual appliance was used with over-torqued lower anterior teeth’s brackets to control the torque of mandibular incisors. After a 30-month treatment, satisfactory smile and facial esthetics and good occlusion was achieved. A 12-month follow-up confirmed that the outcome was stable. Asymmetric molar extraction could be a viable option to retract mandibular incisors in Class III malocclusion with lower dental midline deviation.

scholarly journals Current Trends in Orthognathic Surgery in Poland—A Retrospective Analysis of 124 Cases

2021 ◽  
Vol 11 (14) ◽  
pp. 6439
Author(s):  
Ewa Zawiślak ◽  
Szymon Przywitowski ◽  
Anna Olejnik ◽  
Hanna Gerber ◽  
Paweł Golusiński ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Corrective Osteotomy ◽  
University Hospital ◽  
Class Iii ◽  
Facial Skeleton ◽  
Skeletal Class ◽  
Skeletal Malocclusion ◽  
Current Trends ◽  
Maxillary Osteotomy ◽  
Skeletal Class Ii

The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.

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