A complex orthognathic surgical approach correcting a Class III malocclusion involving traumatic dental injuries and a maxilla fracture.

Abstract

This case report describes a complex approach to orthodontic preparation for surgical treatment of a Class III facial skeletal deformity in a patient who suffered a unilateral maxilla fracture that also featured maxillary left central incisor avulsion, maxillary right central incisor extrusion, and maxillary right lateral luxation. A 12-mm negative overjet was formed by extraction of the maxillary right lateral incisor and closure of the residual space by retraction of the maxillary right central incisor, maxillary left lateral incisors, and maxillary right and left canines. Forward and impaction movement of the maxilla and retrusion and a counterclockwise turning movement of the mandible were then performed. Maxillary first premolars were reshaped to establish a maxillary canine shape, maxillary canines were reshaped to be maxillary lateral incisors, and a maxillary left lateral incisor received a central incisor crown, with a Class II molar relationship with good occlusion after 2years of follow-up. This case was a great challenge that included complex multidisciplinary procedures, and the results indicated successful treatment of an orthodontic preparation for surgical treatment in a patient after maxillary fracture associated with dental trauma.