Abstract
BackgroundClass II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite. Accordingly, the treatment for hyperdivergent skeletal class II malocclusion is a lengthening of the mandibular body length and a counterclockwise rotation of the mandible. To prevent post-operative relapse, botulinum toxin-A (BTX-A) injection can be a retention modality.Case presentationA class II open-bite patient received BTX-A injection to the anterior belly of her digastric muscle for the prevention of post-operative relapse. The relapse was evaluated via a clinical examination and a lateral cephalometric radiograph after the completion of post-surgical orthodontic treatment. The patient showed stable occlusion without any signs of relapse at 15 months post-operatively.ConclusionIn this case presentation, a single injection into the anterior belly of the digastric muscle was sufficient for the prevention of post-operative open bite.
Highlights
BackgroundA skeletal class II malocclusion has a short mandibular body length relative to the maxilla [1]
Class II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite
The treatment for a skeletal class II malocclusion is a lengthening of the mandibular body via ramus osteotomy
Summary
A skeletal class II malocclusion has a short mandibular body length relative to the maxilla [1]. If patients have anterior open bites due to hyperdivergent facial skeletal types, a counterclockwise rotation of the mandible is required. A single injection of BTX-A into the target muscle at the time of surgery may be sufficient to prevent post-operative relapse. Case presentation A 21-year-old female patient was referred from the department of orthodontics to our clinic for orthognathic surgery after the completion of pre-surgical orthodontic treatment She showed anterior open bite with Angle’s class II molar relationship. After all of the surgical procedures, 20 units of botulinum toxin (Meditoxin Type A, Medytox, Seoul, Korea) was injected into the anterior belly of the patient’s digastric muscle using a 1-cc syringe immediately after surgery (Fig. 1). The patient showed stable occlusion without any signs of relapse (Fig. 2) and was satisfied with the esthetic results
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