scholarly journals Orthognathic Surgery with anterior segmental osteotomy as alternative of treatment in patients with dento-skeletal deformity Class III AP maxillary deficiency with dental compensation. Case report.

2020 ◽  
Vol 9 (5) ◽  
pp. 423-429
Author(s):  
Carlos Millán-Golindano ◽  
◽  
Josmar García ◽  
Julio Tebres ◽  
Hans Cordsen ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Class Iii ◽  
Skeletal Deformity ◽  
Dental Compensation ◽  
Facial Changes ◽  
And Function ◽  
Le Fort I ◽  
Maxillary Deficiency ◽  
Skeletal Deformations ◽  
Anterior Posterior

Introduction: Orthognathic surgery is a routine procedure carried out by maxillofacial surgeons in patients with dento-skeletal deformations (DSD) with the objective of achieving functional and esthetical satisfactory results. However, some in cases, due to the decision of the patient or the orthodontic team, the occlusion is tried to be compensated with the intention of avoiding surgery, without optimal results. As a consequence, some extra procedures are required in the surgery to correct and obtain better results. Objective: The aim of this case is to propose the anterior segmental osteotomy (ASO) as alternative of treatment in patients with dento-skeletal deformity class III with maxillary and para-nasal deficiency which have been orthodontically compensated. Material and methods: A 18 years old female with DED Class III due anterior-posterior (AP) maxillary and paranasal deficiency and AP mandibular excess. The surgery was carried out through Le Fort I osteotomy in combination with a segmentary osteotomy at the expense of first premolars and bilateral setback sagittal split osteotomy (BSSO). Clinical and imageology post operatory controls were made during the first 6 months and at two years. Results: Through the realization of the anterior segmental osteotomy the correction of occlusal and transversal alterations of the patient maxilla were performed and additionally favorable facial changes were obtained. Conclusion: The initial orthodontic management of patients with DSD will influence the surgical procedures and the achievement of a balance between esthetics and function. This illustrates why the treatment of these patients must be multidisciplinary; the treatment that was chosen in this case was innovative and could be an alternative for the treatments of patients with DED Class III.

scholarly journals Effect of Le Fort I Maxillary Advancement and Clockwise Rotation on the Anteromedial Cheek Soft Tissue Change in Patients with Skeletal Class III Pattern and Midface Deficiency: A 3D Imaging-Based Prediction Study

2020 ◽  
Vol 9 (1) ◽  
pp. 262
Author(s):  
Hsin-Chih Lai ◽  
Rafael Denadai ◽  
Cheng-Ting Ho ◽  
Hsiu-Hsia Lin ◽  
Lun-Jou Lo
Keyword(s):  
Soft Tissue ◽  
Orthognathic Surgery ◽  
Class Iii ◽  
Le Fort ◽  
Skeletal Class ◽  
Tissue Change ◽  
Maxillary Advancement ◽  
Soft Tissue Change ◽  
Mass Position ◽  
Le Fort I

Patients with a skeletal Class III deformity may present with a concave contour of the anteromedial cheek region. Le Fort I maxillary advancement and rotational movements correct the problem but information on the impact on the anteromedial cheek soft tissue change has been insufficient to date. This three-dimensional (3D) imaging-assisted study assessed the effect of surgical maxillary advancement and clockwise rotational movements on the anteromedial cheek soft tissue change. Two-week preoperative and 6-month postoperative cone-beam computed tomography scans were obtained from 48 consecutive patients who received 3D-guided two-jaw orthognathic surgery for the correction of Class III malocclusion associated with a midface deficiency and concave facial profile. Postoperative 3D facial bone and soft tissue models were superimposed on the corresponding preoperative models. The region of interest at the anteromedial cheek area was defined. The 3D cheek volumetric change (mm3; postoperative minus preoperative models) and the preoperative surface area (mm2) were computed to estimate the average sagittal movement (mm). The 3D cheek mass position from orthognathic surgery-treated patients was compared with published 3D normative data. Surgical maxillary advancement (all p < 0.001) and maxillary rotation (all p < 0.006) had a significant effect on the 3D anteromedial cheek soft tissue change. In total, 78.9%, 78.8%, and 78.8% of the variation in the cheek soft tissue sagittal movement was explained by the variation in the maxillary advancement and rotation movements for the right, left, and total cheek regions, respectively. The multiple linear regression models defined ratio values (relationship) between the 3D cheek soft tissue sagittal movement and maxillary bone advancement and rotational movements of 0.627 and 0.070, respectively. Maxillary advancements of 3–4 mm and >4 mm resulted in a 3D cheek mass position (1.91 ± 0.53 mm and 2.36 ± 0.72 mm, respectively) similar (all p > 0.05) to the 3D norm value (2.15 ± 1.2 mm). This study showed that both Le Fort I maxillary advancement and rotational movements affect the anteromedial cheek soft tissue change, with the maxillary advancement movement presenting a larger effect on the cheek soft tissue movement than the maxillary rotational movement. These findings can be applied in future multidisciplinary-based decision-making processes for planning and executing orthognathic surgery.

scholarly journals 3d Evaluation of Soft Tissue Changes Following Class III Orthognathic Surgery– A Systematic Review

2020 ◽  
pp. 31-38
Author(s):  
Dr. Janani Jayapal ◽  
Dr. Abinaya Somaskandhan ◽  
Dr. Ratna Parameswaran ◽  
Dr. Devaki Vijayalakshmi
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Orthognathic Surgery ◽  
Class Iii ◽  
Mandibular Setback ◽  
Open Access Journals ◽  
Tissue Changes ◽  
Soft Tissue Changes ◽  
Meta Analyses ◽  
Le Fort I

Bac kground:The principlegoal of orthognathic surgery is to establish a balanced and stable dento-skeleto facial complex. This mandates the surgeon and the orthodontist to be able to predict the soft tissue changes to the orthognathic surgery precisely, which is accurately possible using 3-D imaging. Aims: To evaluate the soft tissue changes following class III orthognathic surgery using 3-D imaging. Settings and Design: Systematic review. Methods and Material:This review was conducted according to Preferred Reporting Items for Systematic Reviews and meta-Analyses guidelines systematically searching the six databases including PubMed, Cochrane, Google Scholar, LILACS, Directory of Open Access Journals, and OpenGrey. Statistical analysis used:Not applicable. Results: This systematic review comprises of most UpTo Date evidence from eleven articles answering the review questions. Conclusion: Le Fort I advancement shows significant increase in the alar width, alar cinch, upper lip, chelion, labiale superius, crista philtri, pronasale and subnasale. Mandibular setback shows significant backward movement of soft tissue point B, labialeinferius and subnasale and chin.

Effects of Orthognathic Surgery on Nasal Form and Function in the Cleft Patient

1992 ◽  
Vol 29 (6) ◽  
pp. 546-555 ◽  
Author(s):  
Larry M., Wolford
Keyword(s):  
Orthognathic Surgery ◽  
Treatment Approach ◽  
Nasal Reconstruction ◽  
Le Fort I Osteotomy ◽  
Patient Case ◽  
Form And Function ◽  
Common Problems ◽  
Case Presentations ◽  
And Function ◽  
Le Fort I

Management of common problems of nasal airway obstruction in cleft and noncleft patients by the subnasal approach through the maxillary Le Fort I osteotomy are discussed. The effects of maxillary surgical repositioning on the esthetics of the nose and upper lip are presented, as well as the sequencing and timing of orthognathic surgery and nasal reconstruction in the cleft patient. Case presentations illustrate the results of this treatment approach.

scholarly journals Correction of Mandibular Prognathism by Orthognathic Surgery in a Patient with Acromegaly

2013 ◽  
Vol 2 (1) ◽  
pp. 32-34
Author(s):  
Kamal Gharnizadeh ◽  
Alireza Mohammadi ◽  
Zahra Malekpoor ◽  
Maryam Sohrabi
Keyword(s):  
Orthognathic Surgery ◽  
Growth Form ◽  
Clinical Syndrome ◽  
Class Iii ◽  
Skeletal Deformity ◽  
Slow Progression ◽  
Endocrine Status ◽  
The Face ◽  
Surgery Outcomes

Background: Acromegaly, a condition which is associated with an acquired progressive disfigurement mainly involving the face and extremities, is a clinical syndrome which results from excessive production of growth hormone (GH) most commonly due to adenoma of the pituitary gland. Acromegaly is a rare disease which due to its slow progression, is mostly diagnosed in late adulthood. Bilateral symmetrical prognathic mandible is considered as a diagnostic symptom of acromegaly. Nowadays, orthognathic surgery is done for treatment of this skeletal deformity; however, because of its relapse after surgery, the efficacy of this procedure remains uncertain.Case report: In this report we present a 33 years old man who was admitted for correction of Prognathism resulted from acromegaly in Bou-Ali Hospital. Class III skeletal growth form was achieved in his cephalometry analysis. Macroglossia, concave profile with prominent supra orbital ridges, prognathism, large lips and bulbous nose were detected in his physical examination. Orthognathic surgery as well as median glossectomy was performed and after 1 year follow up no recurrence was detected.Conclusion: It is assumed that keeping GH in a normal range before the surgery and also evaluation of orthognathic aspect and endocrine status of the patient in the follow ups are effective in preservation of orthognathic surgery outcomes.

scholarly journals Combination of expansion and orthognathic surgery in a severe hyperdivergent skeletal Class III malocclusion

2016 ◽  
Vol 6 ◽  
pp. 312-318
Author(s):  
Anadha Gujar ◽  
M. S. Rani ◽  
Sujala G. Durgekar
Keyword(s):  
Growth Pattern ◽  
Orthognathic Surgery ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Maxillary Expansion ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Skeletal Class ◽  
Posterior Crossbite ◽  
Le Fort I

Class III malocclusions with a severe hyperdivergent growth pattern are very complex to plan and treat. This case report describes the treatment of an adult with a skeletal Class III malocclusion with a midface deficiency, severe bilateral posterior crossbite, and a severe hyperdivergent growth pattern by a combination of a bonded rapid maxillary expansion appliance and surgical procedure of Le Fort I osteotomy for maxillary advancement.

scholarly journals Surgical-orthodontic retreatment of a severe skeletal Class III malocclusion following an orthodontic camouflage

2021 ◽  
Vol 26 (4) ◽  
Author(s):  
Francisco MARTINO ◽  
Manuel PEÑA ◽  
Rony JOUBERT
Keyword(s):  
Orthognathic Surgery ◽  
Treatment Plan ◽  
Facial Features ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Treatment Alternative ◽  
Skeletal Class ◽  
Recommended Treatment ◽  
Dentofacial Deformity ◽  
Dental Compensation

ABSTRACT Introduction: Class III malocclusions are some of the most difficult occlusal anomalies to be treated. Some patients with this condition may require orthognathic surgery, while others may be treated with dental camouflage. Proper patient assessment and selection remains critical in order to achieve favorable results. Objectives: This report outlines the case of an 18-year-old male who sought retreatment for a severe skeletal Class III dentofacial deformity after undergoing orthodontic camouflage treatment involving mandibular arch extractions. A treatment plan comprising dental decompensation and orthognathic surgery was implemented in order to achieve optimal facial and occlusal results. Results: After 28 months of treatment, skeletal and dental correction was achieved and facial features were significantly improved. The orthognathic surgery required a 20-mm sagittal maxillomandibular skeletal correction, combined with a 4-mm correction of the midlines and a 2-mm impaction of the maxilla. Conclusion: Dental compensation may be a risky treatment alternative for severe dentoskeletal discrepancies. In these patients, orthodontics combined with orthognathic surgery is the recommended treatment option.

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 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 Surgical correction of vertical maxillary excess associated with mandibular self-rotation

RSBO ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 56-61
Author(s):  
Michelle Nascimento Meger ◽  
Fernanda Tiboni ◽  
Felipe Silvério dos Santos ◽  
Thalyta Verbicaro ◽  
Tatiana Miranda Deliberador ◽  
...  
Keyword(s):  
Case Report ◽  
Orthognathic Surgery ◽  
Rare Condition ◽  
Final Position ◽  
Le Fort I Osteotomy ◽  
Skeletal Deformity ◽  
Le Fort ◽  
Le Fort I ◽  
Gummy Smile

The Class I skeletal deformity associated with vertical maxillary excess is a rare condition reported in the literature. Surgical impaction allows the correction of the long face and gummy smile. Objective: This case report aimed to evaluate the positioning of the condyle after Le Fort I osteotomy associated with mandibular selfrotation. Case report: The patient underwent orthognathic surgery for the correction of maxillary vertical excess. Tomography studies were performed to evaluate the initial and final position of the condyle. The patient improved mastication, breathing and phonetics, with esthetic benefit. Conclusion: After the Le Fort I osteotomy and mandibular self-rotation, the condyle remained stable occupying a new anterior-superior position in the glenoid fossa and patient’s TMJ remained asymptomatic after 9 months of postoperative follow-up.

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