Abstract
Abstract Background A surgery-first approach has many advantages related to a shortened treatment time and an immediate facial aesthetic improvement compared to a three-stage conventional orthognathic surgery protocol. Objective The aim of this case report was to describe the treatment of a 21-year-old, female, patient who presented with a skeletal Class III malocclusion, maxillary retrusion, a negative overjet, an anterior and bilateral posterior cross-bite, and a vertical facial pattern highlighted by a high mandibular plane angle. Methods Orthodontic treatment was performed using self-ligating lingual appliances and a surgery-first approach. The active treatment time was 16 months. Results and conclusion Successful treatment results were achieved using a combination of an orthognathic surgery-first approach and lingual appliances in a patient with high aesthetic expectations.
Highlights
Patients presenting with a skeletal Class III relationship are challenging orthodontic cases due to complex treatment requirements
There is a temporary worsening of the profile prior to surgery, a relatively long treatment time and, during the presurgical orthodontic phase, patients may complain about masticatory problems.[1]
The surgical procedure is performed before orthodontic treatment which means that the teeth are not levelled nor aligned nor placed in their ideal position over the basal bone.[2]
Summary
A surgery-first approach has many advantages related to a shortened treatment time and an immediate facial aesthetic improvement compared to a three-stage conventional orthognathic surgery protocol. Objective: The aim of this case report was to describe the treatment of a 21-year-old, female, patient who presented with a skeletal Class III malocclusion, maxillary retrusion, a negative overjet, an anterior and bilateral posterior cross-bite, and a vertical facial pattern highlighted by a high mandibular plane angle. Methods: Orthodontic treatment was performed using self-ligating lingual appliances and a surgery-first approach. The active treatment time was 16 months. Results and conclusion: Successful treatment results were achieved using a combination of an orthognathic surgery-first approach and lingual appliances in a patient with high aesthetic expectations.
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