Case report on the surgical correction of skeletal Class III by maxillary advancement

2020 ◽  
Vol 11 (1) ◽  
pp. 38
Author(s):  
VenkataNaga Sravanthi Jonnalagadda ◽  
VijayReddy Goskonda ◽  
Deepti Vallapareddy ◽  
Sravani Garepally ◽  
B Jayabharath Reddy
2020 ◽  
Vol 10 (1) ◽  
pp. 1-11
Author(s):  
So-Hyun Kim ◽  
Nam-Ki Lee ◽  
Young-Kyun Kim ◽  
Tae-Hyun Choi

Author(s):  
Vo Truong Nhu Ngoc ◽  
Nguyen Thi Thu Phuong ◽  
Nguyen Viet Anh

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.


2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.


2020 ◽  
Vol 9 (1) ◽  
pp. 262
Author(s):  
Hsin-Chih Lai ◽  
Rafael Denadai ◽  
Cheng-Ting Ho ◽  
Hsiu-Hsia Lin ◽  
Lun-Jou Lo

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.


2020 ◽  
Vol 54 (2) ◽  
pp. 150-156
Author(s):  
Sanjeev Verma

VG, 25-year-old male, presented with c/c of forwardly placed lower jaw and history of unsatisfactory previous orthodontic treatment. Extraorally, the patient had asymmetrical face and concave profile, competent lips, positive lip step, and chin deviated toward left side by 2 mm. Intraorally, the patient had Angle’s class III type 3 malocclusion with an overjet of (–1) mm, overbite of 0%, and cross-bite wrt 12, 21. The patient was skeletal class III due to macrognathic and prognathic mandible with hypodivergent growth pattern, and proclined upper and retroclined lower incisors. The patient was managed orthosurgically with bimaxillary surgery (maxillary advancement 3 mm + mandibular setback 7 mm) after presurgical decompensation. The case report discusses in detail the diagnosis and comprehensive management of the skeletal class III case.


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