Change in the Vertical Relation in Class II Deformity with Skeletal Open Bite in the Orthognathic Surgery

Nezar Watted,Muhamad Abu-Hussein,Josip Bill,Peter Proff,Obaida Awadi

doi:10.13189/ojdom.2015.030103

Abstract

The continuously growing esthetic awareness for the facial appearance and the spreading of information about the possibilities of adult treatment by public media result in an increase of adult patients seek orthodontic treatment to improve their facial esthetics. In general, these patients show such a severe skeletal deformity that it is detectable even by non-experts because of its extraoral manifestation, which is the main motivation for treatment. Because of the nature of these deformities and because of the lacking growth usable for therapy the only promising treatment for these patients is the combined orthodontic-surgical approach. Besides a stable and functional occlusion with physiologic position of the condyle, the goals of treatment are the improvement of the dental and, above all, facial esthetics since the patient judges the success of treatment mostly by the extraoral appearance. The dentofacial appearance must be defined prior to treatment to plan the individual right approach in knowledge of the different treatment possibilities for Angle Class II deformities and thus be able to reach both sides -patient and orthodontist- satisfying result. With this article a systematic therapy concept to treat patients with Class II deformities and skeletal open bite with a long lower face (long face syndrome).

Highlights

Pre-surgical orthodontic preparation was uncommon for patients requiring orthognathic surgery until the 1960’s
The patient complained about pain of the temporomandibular joints when chewing which initiated before the accident and she felt an esthetic impairment because of rotated and crowded upper incisors
The case was treated according to the Würzburg treatment concept for orthognathic correction of a skeletal deformity and consisted of 4 phases .[ 48, 49, 50 ]: I) Presurgery Measures and Orthodontic Setup 1) “Splint therapy”: A flat plane splint was inserted for 5 weeks to establish a physiologic centric relation of the condyles for final treatment planning and to reduce the temporomandibular joint pain

Summary

Introduction

Pre-surgical orthodontic preparation was uncommon for patients requiring orthognathic surgery until the 1960’s. As surgical techniques advanced and the number of patients choosing an orthognathic approach increased, the patients’ and clinicians’ desire for optimal esthetic and

History and Initial Examination

Diagnosis

Treatment Plan and Goals

Treatment

V) Result and Discussion

Conclusions