hrvatski

Combined orthodontic - surgical treatment of severe mandibular prognathism: a case report

Introduction: The present study describes a skeletal Class III malocclusion and aims to provide the clinician with rational guidelines for presurgical orthodontic preparation and postsurgical finishing. Patient and methods: A 17- year old male patient with skeletal class III discrepancy associated with mandibular prognathism and dental compensation, anterior cross bite of -10mm, crowding in both dental arches, missing both upper second premolars and lower left second premolar. Lateral cephalometic analysis confirmed severe class III skeletal discrepancy with significantly mandibular prognathism (SNB= 95.6, ANB= -8.4, WITS= -22.4), mandibular incisors showed compensatory lingual inclination (1-Go-Me= 74.6) Results: Treatment plan was based on cephalometric prediction and model surgery. Presurgical orthodontic treatment included decompensation of occlusion, opening space for lower left second premolar, resulting in reverse overjet of -15mm. Accordingly, surgical plan included maxillary advancement of 8 mm using Le Fort I osteotomy and bisagittal split ramus osteotomy with mandibular setback of 10mm to correct skeletal discrepancy and achieve correct overjet and good facial profile. Jaws were repositioned using titanium miniplates and prefabricated occlusal splints. Postsurgical orthodontic treatment was done with vertical elastics. Ten months after surgery, patient started retention phase with Hawley retainers. Conclusion: Eventhough initial anteroposterior position of maxilla was forward, bimaxillary surgery was performed, due to 18mm of mandibular setback requirement which could cause a relapse, leading to a satisfactory occlusal, functional and aesthetic result. An interdisciplinary treatment involves good diagnosis and intense communication between orthodontist and maxillofacial surgeon, in order to achieve good outcomes in complex orthodontic and surgical cases

mandibular prognathism ; orthodontic treatment ; orthognathic surgery

nije evidentirano

engleski

Combined orthodontic - surgical treatment of severe mandibular prognathism: a case report

Introduction: The present study describes a skeletal Class III malocclusion and aims to provide the clinician with rational guidelines for presurgical orthodontic preparation and postsurgical finishing. Patient and methods: A 17- year old male patient with skeletal class III discrepancy associated with mandibular prognathism and dental compensation, anterior cross bite of -10mm, crowding in both dental arches, missing both upper second premolars and lower left second premolar. Lateral cephalometic analysis confirmed severe class III skeletal discrepancy with significantly mandibular prognathism (SNB= 95.6, ANB= -8.4, WITS= -22.4), mandibular incisors showed compensatory lingual inclination (1-Go-Me= 74.6) Results: Treatment plan was based on cephalometric prediction and model surgery. Presurgical orthodontic treatment included decompensation of occlusion, opening space for lower left second premolar, resulting in reverse overjet of -15mm. Accordingly, surgical plan included maxillary advancement of 8 mm using Le Fort I osteotomy and bisagittal split ramus osteotomy with mandibular setback of 10mm to correct skeletal discrepancy and achieve correct overjet and good facial profile. Jaws were repositioned using titanium miniplates and prefabricated occlusal splints. Postsurgical orthodontic treatment was done with vertical elastics. Ten months after surgery, patient started retention phase with Hawley retainers. Conclusion: Eventhough initial anteroposterior position of maxilla was forward, bimaxillary surgery was performed, due to 18mm of mandibular setback requirement which could cause a relapse, leading to a satisfactory occlusal, functional and aesthetic result. An interdisciplinary treatment involves good diagnosis and intense communication between orthodontist and maxillofacial surgeon, in order to achieve good outcomes in complex orthodontic and surgical cases

mandibular prognathism ; orthodontic treatment ; orthognathic surgery

nije evidentirano