Abstract
Our objective was to report the orthodontic and surgical retreatment of a patient who had undergone a prolonged orthodontic treatment with extractions, but who had unsatisfactory results and persistent side effects. The man, aged 25years 3months, sought treatment with major complaints of facial and smile asymmetries. The clinical examination showed a mandibular deviation to the right and a maxillary occlusal cant. A Class II Division 1 subdivision right was observed. Radiographic examination showed extensive root resorptions in the maxillary second premolars and absence of the 4 first premolars. The maxillary midline was deflected 2mm to theleft, and the mandibular midline was shifted 5mm to the right. Aligning and leveling were performed with orthodontic fixed appliances, with a standard edgewise system (0.022×0.028 in), followed by LeFort I maxillary impaction and bilateral sagittal split osteotomy with asymmetrical advancement. Retreatment showed outstanding results that remained stable after 3years of follow-up. Root resorption in the second premolars did not seem to increase. Orthodontic-surgical intervention is the main choice for correcting esthetic and functional problems in facial asymmetry, particularly in cases of retreatment.
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