Orthognathic Surgery for Treatment of Angle Class III Deformity - Clinical Case Report
Andréa Juliana Luz Perdigão*, Rubens Gonçalves Teixeira, Marilia de Oliveira Coelho Dutra Leal and Claudio Roberto Pacheco Jodas
Department of Maxillofacial Surgery and Traumatology, Sao Leopoldo Mandic,
Campinas, Sao Paulo, Brazil
*Corresponding Author: Andréa Juliana Luz Perdigão, Department of Maxillofacial Surgery and Traumatology, Sao Leopoldo Mandic, Campinas, Sao Paulo, Brazil.
Received: March 09, 2023; Published: April 17, 2023
Orthognathic surgery is performed to correct large discrepancies between the jaws and severe malocclusion, with a focus on improving facial function and aesthetics, providing a stable postoperative occlusion. A 23- year-old Caucasian female patient attended private outpatient care of Oral and Maxillofacial Surgery and Traumatology, by dentist Andréa Juliana Luz Perdigão, diagnosed with dentofacial deformity. The clinical dental examination, based on the concepts proposed by Arnett Gunson, revealed a Class III dentofacial deformity, a Class III occlusal relationship, anteroposterior maxillary deficiency, bilateral and anterior crossbite with mandibular prognathism. Two surgical stages (disjunction and after six months, orthognathic surgery) were proposed and chosen as a treatment plan by the patient. Six months after disjunction, bimaxillary orthognathic surgery was performed, with Le Fort I type osteotomy in the maxilla and bilateral sagittal osteotomy of the mandible. The Recommended movements were 0 mm lower maxillary repositioning, 9 mm maxillary advancement; 3 mm retrusion in the mandible. The objective of the present case report, functional and aesthetic, was successfully achieved through orthognathic surgery, the patient is in skeletal and dental Class I after the procedure.
Keywords: Maxilla; Le Fort I; Maxillary Osteotomy; Orthodontics
- Kim YJ and Lee BK. “Recent Trends in Orthognathic Surgery in Asia”. Facial Plastic Surgery Clinics of North America 4 (2021): 549-566.
- Cao L., et al. “Effect of maxillary incisor labiolingual inclination and anteroposterior position on smiling profile esthetics”. Angle Orthodontist1 (2011).
- Baan F., et al. “Virtual occlusion in orthognathic surgery”. International Journal of Oral and Maxillofacial Surgery 50 (2021): 1219-1225.
- Posnick JC. “Orthognathic Surgery: Past-Present - Future”. Journal of Oral and Maxillofacial Surgery 79 (2021): 1996-1998.
- Huang CS., et al. “Systematic Review of the Surgery-first Approach in Orthognathic Surgery Chiung”. Journal of Biomedical Science 37 (2014): 184-190.
- Sullivan SM. “Le Fort I Osteotomy”. Atlas of the Oral and Maxillofacial Surgery Clinics of North America 1 (2015): 1-13.
- Cariati P., et al. “Psycho-social Impact of Orthognathic Surgery”. Journal of Clinical and Experimental Dentistry 5 (2016): e540-545.
- Jandali D and Barrera JE. “Recent Advances in Orthognathic Surgery”. Current Opinion in Otolaryngology and Head and Neck Surgery 28 (2020): 246-250.
- Cao RK., et al. “Application of three-dimensional technology in orthognathic surgery: a narrative review”. European Review for Medical and Pharmacological Sciences 26 (2022): 7858-7865.
- Elnagar MH., et al. “Digital Workflow for Combined Orthodontics and Orthognathic Surgery”. Oral and Maxillofacial Surgery Clinics of North America 32 (2020): 1-14.
- Lin HH., et al. “3D printing in orthognathic surgery - A literature review”. Journal of the Formosan Medical Association 117 (2018): 547-558.
- Andrews WA. “AP Relationship of the Maxillary Central Incisors to the Forehead in Adult White Females”. Angle Orthodontist 78 (2008): 4.
- Gidaly MP., et al. “Optimal Anteroposterior Position of the Maxillary Central Incisors and its Relationship to the Forehead in Adult African American females”. Angle Orthodontist 89 (2019): 1.
- Resnick CM., et al. “Evaluation of Andrews’ Analysis as a predictor of Ideal Sagittal Maxillary Positioning in Orthognathic Surgery”. Journal of Oral and Maxillofacial Surgery 76 (2018): 2169-2176.
- Lopatiene K., et al. “Vertical and sagittal morphology of the facial skeleton and the pharyngeal airway”. Stomatologija, Baltic Dental, and Maxillofacial Journal 18 (2016): 21-25.
- Arnett GW., et al. “Combined orthodontic and surgical open bite correction: Principles for success. Part 1”. Angle Orthodontist 92 (2022): 2.
- Klein KP., et al. “Orthognathic Surgery and orthodontics Inadequate Planning Leading to Complications or Unfavorable Results”. Oral and Maxillofacial Surgery Clinics of North America 32 (2020): 71-82.
- Martino F., et al. “Surgical-orthodontic retreatment of a severe skeletal class III malocclusion following an orthodontic camouflage”. Dental Press Journal of Orthodontics4 (2021): e2119247.
- Arnett GW., et al. “Combined orthodontic and surgical open bite correction: Principles for success. Part 2”. Angle Orthodontist 92 (2022): 431-445.
- Monnet-Corti V., et al. “Perfecting smile esthetics: keep it pink”. Orthodontie Française 1 (2018): 71-80.
- Bell WH and Jacobs JD. “Surgical-Orthodontic Correction of Maxillary Retrusion by Le Fort I Osteotorny and Proplast”. Journal of Maxillofacial and Oral Surgery 2 (1980): 84-94.
- Carvalho PHA., et al. “Surgically assisted rapid maxillary expansion: a systematic review of complications”. International Journal of Oral and Maxillofacial Surgery (2019).
- Thiesen G., et al. “Facial Asymmetry: A Current Review”. Dental Press Journal of Orthodontics6 (2015) :110-125.
- Alkhayer A., et al. “Accuracy of virtual planning in orthognathic surgery: a systematic review”. Head and Face Medicine (2020): 16-34.
- Gandini LG., et al. “Unesp Araraquara cephalometric analysis”. Revista Dental Press de Ortodontia e Ortopedia Facial 10 (2005): 1.
- Hisset EC. “Case Report”. The Angle Orthodontist 4 (1980): 340-345.
- Kotula J., et al. “New Sagittal and Vertical Cephalometric Analysis Methods: A Systematic Review”. Diagnostics (Basel)7 (2022): 1723.
- Carruitero MJ., et al. “Glabellar vertical line as a reference goal for the anteroposterior maxillary position”. Dental Press Journal of Orthodontics3 (2019): 45.e1-45. e5.
- Menezes EBC., et al. “Do different vertical positions of maxillary central incisors influence smile esthetics perception?”. Dental Press Journal of Orthodontics 2 (2017): 95-105.