Three-dimensional evaluation of skeletal and dental changes in patients with skeletal class III malocclusion and facial asymmetry after surgical-orthodontic treatment

Abstract The mandibular proximal ramus segments should be moved and rotated during orthognathic surgery-based skeletofacial reconstruction for the correction of challenging patients with facial asymmetry and malocclusion, but quantitative data regarding this rotation were not sufficient to date. This 3D computer-assisted study measured the proximal ramus segment rotation after 3D simulation-guided two-jaw surgery in patients with facial asymmetric deformity and class III malocclusion (n = 31). Using 3D mandible models and a reliable proximal ramus segment-related plane, angular changes in pitch, roll and yaw directions were measured before and one month after surgery. Significant rotational changes (p < 0.01) were observed in the left and right sides and overall proximal ramus segments after surgery, with absolute differences of 4.1 ± 3.0 (range −7.8 to 6.9), 2.8 ± 2.3 (−8.8 to 5.0), and 2.7 ± 2.4 (−6.6 to 9.9) degrees in pitch, roll, and yaw rotations, respectively. Numbness and mouth opening limiting occurred within the first 6 months after surgery but the patients had an unremarkable long-term postoperative course, with no revisionary surgery required. This study contributes to the multidisciplinary-related literature by revealing that proximal ramus segment rotation and rigid fixation with no postoperative intermaxillary immobilization was practicable in skeletofacial surgery for the successful treatment of asymmetric deformity and class III malocclusion.

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Three-dimensional analysis of lip soft tissue changes and related jaw changes in patients with skeletal class III malocclusion and facial asymmetry

Journal of X-Ray Science and Technology ◽

10.3233/xst-210903 ◽

2021 ◽

pp. 1-14

Author(s):

Wenjie Xu ◽

Hao Tan ◽

Xuehuan Meng ◽

Ye Ming ◽

Tao Wang ◽

...

Keyword(s):

Soft Tissue ◽

Orthognathic Surgery ◽

Three Dimensional ◽

Facial Asymmetry ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Tissue Changes ◽

Soft Tissue Changes ◽

Jaw Surgery

OBJECTIVE: To investigate three-dimensional soft tissue changes of lips and related jaw changes in patients with skeletal class III malocclusion and facial asymmetry using cone-beam computerized tomography (CBCT). METHOD: This study included 46 CBCT scans of patients with aforementioned character before (T1) and 6–12 months after orthognathic surgery (T2). Subjects were divided into 2 groups according to two types of orthognathic surgery namely, the one-jaw surgery group who underwent bilateral sagittal splint ramus osteotomy (BSSRO) and the two-jaw surgery group who underwent Le Fort I osteotomy and BSSRO. Mimics 19.0 software are used for model reconstruction, landmark location and three-dimensional cephalometric analysis. Descriptive statistics and correlation analyses are used to investigate jaw hard tissue and lip soft tissue changes. RESULTS: In one-jaw group, the mandible shows changes in contour and position (p < 0.05), and the surgery causes changes of lip structure on the deviated side. While in two-jaw group, jaws only show changes in spatial position, and surgery changes contour of bilateral lips and nasolabial angle (p < 0.05). At the same time, lip symmetry increases significantly in both groups postoperatively. CONCLUSIONS: Orthognathic surgery can improve lip aesthetics in patients with skeletal class III malocclusion and facial asymmetry. However, changes induced by two surgical approaches are different. Surgeons should have a clear acquaintance with this difference to deal with different situations.

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Camouflage treatment for skeletal Class III patient with facial asymmetry using customized bracket based on CAD/CAM virtual orthodontic system:

The Angle Orthodontist ◽

10.2319/102318-768.1 ◽

2019 ◽

Vol 90 (4) ◽

pp. 607-618

Author(s):

Ha Na Sha ◽

Sun Young Lim ◽

Sun Mi Kwon ◽

Jung-Yul Cha

Keyword(s):

Computer Aided Design ◽

Orthodontic Treatment ◽

Facial Asymmetry ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Mandibular Asymmetry ◽

Computer Aided ◽

Cad Cam ◽

Aided Design

ABSTRACT When considering camouflage orthodontic treatment for Class III malocclusion with skeletal facial asymmetry, it is crucial to preserve the favorable compensated posterior occlusion. Once the inclination of the compensated occlusion is changed during orthodontic treatment, unstable occlusion, such as crossbite or scissor bite may occur. A 23-year-old female patient had anterior spacing with Class III malocclusion and a mandibular asymmetry. A nonsurgical approach was adopted. The treatment objectives were to establish a Class I molar relationship with compensated inclination of the posterior dentition and to correct the midline deviation. To achieve these goals, the computer-aided design/computer-aided manufacturing (CAD/CAM) orthodontic system plus customized brackets was applied, and miniscrews were used to distalize the left mandibular dentition for midline correction. The results suggested that the CAD/CAM-based customized brackets can be efficiently used in camouflage treatment to achieve a correct final occlusion.

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ISW for the Treatment of Facial Asymmetry Crossbite Case with Upper Right Lateral Incisor Missing

International Journal of Experimental Dental Science ◽

10.5005/jp-journals-10029-1028 ◽

2012 ◽

Vol 1 (2) ◽

pp. 113-117

Author(s):

Chia-bin SUN ◽

Jian-hong YU

Keyword(s):

Orthodontic Treatment ◽

Medical Center ◽

Treatment Plan ◽

Facial Asymmetry ◽

Functional Class ◽

Lateral Incisor ◽

Tini Alloy ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class

ABSTRACT Class III malocclusion with facial asymmetry is difficult to treat with orthodontic treatment without surgery. Skeletal class III malocclusion can be treated with surgery or orthodontic treatment by camouflage. Functional class III malocclusion can be treated perfectly by orthodontic treatment, using the intermaxillary elastics (IME) to correct the jaw relation. Differentially, diagnosing a class III case is important before deciding the treatment plan. We must understand the type of class III malocclusion and then we can make the best choice for the patient. This article reports the treatment of adult class III malocclusion by the improved superelastic TiNi alloy wire (ISW). Using the ISW crossbite arch, coil springs and IME, adequate overbite and overjet were achieved and better facial symmetry was also improved. How to cite this article SUN Cb, YU Jh. ISW for the Treatment of Facial Asymmetry Crossbite Case with Upper Right Lateral Incisor Missing. Int J Experiment Dent Sci 2012;1(2): 113-117. Source of support This work was supported by China Medical University and Medical Center, Taichung City, Taiwan (Grant number: CMU97-080 (2008) to JH YU).

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Surgical-orthodontic treatment of Class III malocclusion with agenesis of lateral incisor and unerupted canine

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512013000300015 ◽

2013 ◽

Vol 18 (3) ◽

pp. 94-100 ◽

Cited By ~ 1

Author(s):

Bruno Boaventura Vieira ◽

Ana Carolina Meng Sanguino ◽

Marilia Rodrigues Moreira ◽

Elizabeth Norie Morizono ◽

Mírian Aiko Nakane Matsumoto

Keyword(s):

Orthodontic Treatment ◽

Facial Asymmetry ◽

Dental Arch ◽

Class Iii ◽

Class Iii Malocclusion ◽

Mandibular Growth ◽

Skeletal Class ◽

Impacted Canine ◽

The Face ◽

Prolonged Retention

INTRODUCTION: Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch. METHODS: The pre-surgical orthodontic treatment was performed with extractions of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the post-surgical orthodontic treatment was finished. RESULTS: The Class III malocclusion was treated establishing occlusal and facial normal standards.

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