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Combined Orthodontics and Orthognatic Surgery for the correction of class II skeletal malocclusion in an adult patient

INTRODUCTION: Correction of skeletal deformities in adult patients only with orthodontics is limited. Orthodontics combined with orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting vertical maxillary excess along with class II skeletal deformity. METHODS: The present case report is about a 22-year-old female patien with a chief complaint of severely protruding upper front teeth, inabitity to close the lips and excessive visibility of gums in the upper arch during smile. The case was started with pre adjusted edgewise appliance using 0.022 slot MBT prescription. Upper premolars were extracted as planned for pre-surgical orthodontics. Superior repositioning of the maxilla was done with LeFort I osteotomy to reduce the vertical excess and allows the mandible to rotate upward and forward, which simultaneously shortens facial height. To provides much more chin prominence advancement genioplasty was done. RESULTS: The results satisfied the primary complaint of the patient. The patient's facial appearance was markedly improved along with functional and stable occlusion. The pre-surgical and post-surgical cephalometric values and superimpositions showed a dramatic skeletal and dental improvement. INTRODUCTION: Correction of skeletal deformities in adult patients only with orthodontics is limited. Orthodontics combined with orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting vertical maxillary excess along with class II skeletal deformity. METHODS: The present case report is about a 22-year-old female patien with a chief complaint of severely protruding upper front teeth, inabitity to close the lips and excessive visibility of gums in the upper arch during smile. The case was started with pre adjusted edgewise appliance using 0.022 slot MBT prescription. Upper premolars were extracted as planned for pre-surgical orthodontics. Superior repositioning of the maxilla was done with LeFort I osteotomy to reduce the vertical excess and allows the mandible to rotate upward and forward, which simultaneously shortens facial height. To provides much more chin prominence advancement genioplasty was done. RESULTS: The results satisfied the primary complaint of the patient. The patient's facial appearance was markedly improved along with functional and stable occlusion. The pre-surgical and post-surgical cephalometric values and superimpositions showed a dramatic skeletal and dental improvement.

Class II malocclusion; ortodontics; orthognatic surgery

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