Corrección ortodóncico-quirúrgica de clase III esquelética a través de avance y descenso del maxilar con injerto óseo. Caso clínico

Abstract

Class III malocclusion can involve a lot of factors such as excessive mandibular growth, deficient maxillary growth, other environmental factors and maxillary trauma. The correction of this malocclusion can be with orthodontic treatment (camouflage) and when there is a more significant bone discrepancy, esthetic or functional problems; it can be solved with a combination of orthodonticsurgical treatment. In this case report, a 17-year-old patient with a dental and maxillofacial deformity (Angle class III malocclusion) due to a deficient vertical and sagittal maxillary growth, with no transverse discrepancy; excessive mandibular growth, brachyfacial with concave profile, a 1mm incisor display when smiling which had a major impact on the patient's aesthetic perception of herself. An orthodontic-surgical treatment was planned using Roth 0.018″×0.025″ slot appliances. The surgical treatment was a maxillary inferior repositioning and advancement using an autogenous chin graft. Maxillary segmentation was performed to coordinate both arches. Le Fort I surgery is an effective procedure in the correction of dentofacial discrepancies with maxillary deficiency. The aesthetic and functional results obtained by using this type of surgery were successful and treatment was continued with postsurgical-orthodontic treatment to get a detailed finishing of the case. ConclusionsMaxillary repositioning is used nowadays to achieve long term stability in the correction of class III skeletal discrepancies, when in the past the only solution was to treat with mandibular surgery only, thus producing poor facial aesthetics.