Abstract
Background: The demand for interdisciplinary orthodontic treatment has increased significantly in the past few years, especially in adult patients. This kind of treatment requires careful clinical management, as consequence of the possible complications and limits related to adult age. However, the use of skeletal anchorage and three-dimensional (3D) digital technology has deeply revolutionised diagnostic planning and treatment strategies. Methods: A fully digital approach to the treatment of a Class II patient with a gummy smile and mandibular deficiency and deviation, consisting of initial surgery followed by the use of aligners and skeletal anchorage, is described. Results: The 3D, fully digital pre-evaluation enabled clinicians to accurately and reliably plan the surgical procedure and subsequent orthodontics, including the individualised positioning of stabilisation plates and a splint for maxillary and chin surgical movements. This allowed for the improvement of the patient’s facial aesthetics and dental occlusion without the use of visible orthodontic appliances or the occurrence of pre-surgical aesthetic worsening. Conclusions: This approach could be very effective for adult patients seeking aesthetic treatment options for facial and dental aesthetic improvement.
Highlights
Three-dimensional (3D) digital technology has deeply revolutionised the diagnostic planning and treatment strategies used in medical surgeries, including orthognathic surgery
The introduction of 3D imaging in orthodontics, the visualisation and pre-determination of orthodontic movements, and the relative results have all laid the foundation for the advent of, and explosion in, the use of aligners, which has had significant benefits for patients, mainly in terms of aesthetics [9,10]
Total treatment time was 15 months, which was slightly increased by the subsequent finishing phase using the aligners and the periodontal aesthetic optimisation
Summary
Three-dimensional (3D) digital technology has deeply revolutionised the diagnostic planning and treatment strategies used in medical surgeries, including orthognathic surgery. Intra-oral scanning, 3D digital models, 3D facial soft tissue scans, and cone-beam CT scans have made it possible to view patients’ 3D virtual anatomical structures, and 3D virtual surgical planning has emerged as a comprehensive and precise approach to treating orofacial deformities [1,2] This has allowed for a simplified alternative approach to the conventional three-step treatment sequence (pre-surgical orthodontics, surgery, post-surgical orthodontics). Results: The 3D, fully digital pre-evaluation enabled clinicians to accurately and reliably plan the surgical procedure and subsequent orthodontics, including the individualised positioning of stabilisation plates and a splint for maxillary and chin surgical movements This allowed for the improvement of the patient’s facial aesthetics and dental occlusion without the use of visible orthodontic appliances or the occurrence of pre-surgical aesthetic worsening. Conclusions: This approach could be very effective for adult patients seeking aesthetic treatment options for facial and dental aesthetic improvement
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