Multidisciplinary Treatment of Skeletal Class III Malocclusion with Orthognathic Surgery: Two Case reports

Year 2020, Volume: 11 Issue: 4, 500 - 506, 31.12.2020

Muhammed Hilmi Buyukcavus Yavuz Fındık Timuçin Baykul

Abstract

Objectives: This case report presents the treatment of two patients with skeletal Class III malocclusion, performed in collaboration with orthodontics and surgery. Case: The main complaint of our patients is negative facial aesthetics; it was observed that it had a concave profile in the extraoral examination, and the right and left canine and molar relationships were Class III on intraoral examination. In the treatment plan, following leveling and decompensation in the lower and upper dental arch with fixed orthodontic treatment, in the first case, 6 mm mandibular set back was performed with sagittal split ramus osteotomy; in the second case, bimaxillary orthognathic surgery (4 mm maxillary advancement ve 4 mm mandibular set-back) was performed. Conclusion: With orthodontic treatment performed after surgery, the occlusion was corrected by bringing the teeth to their proper positions, and at the end of the treatment, a ideal soft tissue with skeletal and dental Class I relationship was achieved.

Keywords

Class III malocclusion, orthognathic surgery, orthodontic treatment

İskelet Sınıf III Maloklüzyonunun Ortognatik Cerrahi ile Multidisipliner Tedavisi: İki Olgu Sunumu

Abstract

Amaç: Bu olgu sunumu, iskeletsel Sınıf III maloklüzyonlu iki hastanın ortodonti ve cerrahi işbirliği ile yapılan tedavisini sunmaktadır. Olgu: Hastalarımızın temel şikâyeti olumsuz yüz estetiğidir; ekstraoral muayenede içbükey bir profile sahip oldukları, ağız içi muayenede sağ ve sol kanin ve molar ilişkilerinin Sınıf III olduğu görülmüştür. Tedavi planında sabit ortodontik tedavi ile alt ve üst dental arklarda seviyeleme-hizalama ile dekompansasyon yapıldıktan sonra ilk olguda sagittal split ramus osteotomisi ile 6 mm mandibula geri alındı; ikinci olguda bimaksiller ortognatik cerrahi (4 mm maksiller ilerletme ve 4 mm mandibular set-back) yapıldı. Sonuç: Ameliyat sonrası yapılan ortodontik tedavi ile dişler uygun pozisyonlarına getirilerek oklüzyon düzeltildi ve tedavi sonunda iskelet ve dişsel Sınıf I ilişkisi ile ideal bir yumuşak doku profili elde edildi.

Keywords

Sınıf III maloklüzyon, ortognatik cerrahi, ortodontik tedavi

References

• 1. Guyer EC, Ellis EE, McNamara JA, Behrents RG. Components of Class III malocclusion in juveniles and adolescents. Angle Orthod. 1986;(56):7–29.
• 2. Uslu O, Akcam MO. Evaluation of long-term satisfaction with orthodontic treatment for skeletal Class III individuals. J Oral Sci. 2007;49(1):31-39.
• 3. Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. 4th Ed. St. Louis: Mosby Elsevier. 2007.
• 4. Janson G. Extreme Dentoalveolar Compensation in the Treatment of Class III Malocclusion. Am J Orthod Dentofacial Orthop. 2005;128:787-94.
• 5. Moullas A, Palomo JM, Gass JR, Amberman BD, White J, Gustovich D. Nonsurgical treatment of a patient with a Class III malocclusion. Am J Orthod Dentofac Orthop. 2006;129:111-18.
• 6. Pancherz H. Dentofacial orthopedics or orthognathic surgery: is it matter of age? Am J Orthod Dentofacial Orthop. 2000;117:571-574.
• 7. Güngör AY, Turkkahraman H, Baykul T, Aydın A. İskeletsel Sınıf III Malokluzyonun Ortognatik Cerrahi Tedavisi: Olgu Raporu. SDÜ Sağ Bil Derg. 2012;3(2):85-88.
• 8. Delaire J. Maxillary development revisited: rele¬vance to the orthopedic treatment of Class III ma¬locclusions. Eur J Orthod 1997;19:289–311.
• 9. Bergamo AZN, Andrucioli MCD, Romano FL, Ferreira JTL, Matsumoto MAN. Orthodontic–surgical treatment of class III malocclusion with mandibular asymmetry. Braz. Dent. J. 2011;22:151–56.
• 10. Guven O. Sınıf III vakalarında ortognatik cerrahi (vaka raporu). Türk Ortodonti Derg. 1998;1:245–48.
• 11. Enacar A, Aksoy AÜ. Ortognatik cerrahi uygulanmış vakalarda profil değişiklikleri. Türk Ortodonti Derg. 1988;1:80–89.
• 12. Egbert M, Hepworth B, Myall R, West R. Stability of LeFort I osteotomy with maxillary advancement: a comparison of combined wire fixation and rigid fixation. J Oral Maxillofac Surg 1995;53:243-8.
• 13. Wagner S, Reyneke JP. The LeFort I downsliding osteotomy: a study of long-term hard tissue stability. Int J Adult Orthod Orthognath Surg. 2000;15:37-49
• 14. Başçiftçi FA, Orhan M, Uçkan S, Üşümez S. İskeletsel Sınıf III Olgularda Ortodontik-Cerrahi Yaklaşımlar (İki Vaka Raporu). T Klin Diş Hek Bil. 2001;7:138-44.