Orthodontic-Surgical Approach for Treating Skeletal Class III Malocclusion: About A Case Report

Abstract

Class III skeletal malocclusions are considered to be ones of the most challenging deformities for orthodontists, they may present several forms, among which maxillary deficiency is the most frequent. This type of malocclusion is usually treated with combination of orthodontics and orthognathic surgery in order to obtain an adequate occlusion and facial esthetics. This report presents the treatment of a young female patient aged 16 years and 4 months with Class III skeletal malocclusion, and a severe anterior crowding with palatal displacement of the maxillary lateral incisors and ectopic canines, as well as an Angle Class I molar relationship occlusion on both sides associated with significant dento-alveolar compensation : The upper incisors were proclined while the lower incisors were vertical, and a maxillary midline shift .Clinical examination has also revealed a retrusive maxilla, underdeveloped cheekbones, and a flat facial profile. The treatment was performed in three phases: first, presurgical orthodontic preparation including extraction of the maxillary first premolars and mandibular second premolars in order to perform the orthodontic decompensation, secondly, orthognathic surgery which consists of maxillary advancement to improve soft-tissue projection of the midface, and finally, orthodontic finishing for the conclusion of the case. At the end of the treatment, the main objectives were successfully achieved, providing the patient with adequate masticatory function, pleasant facial esthetics and especially better self-esteem.