Orthosurgical Management of a Severe Class III Malocclusion

Abstract

Success in the management of a skeletal Class III malocclusion depends on proper diagnosis and treatment planning. In adults with a severe discrepancy, combined orthosurgical approach is the only way to achieve acceptable results. This case report describes the orthosurgical management of an adult male patient with a severe Class III malocclusion displaying a combination of maxillary deficiency and mandibular excess. The patient had a reverse overjet of 5 mm and an open bite of 7 mm. Incisal display both at rest as well as on smiling was decreased and he presented with a wide buccal corridor. A combination of Arnett’s clinical and cephalometric examination was used to diagnose and plan treatment for facial changes. Double jaw surgery including a 4 mm maxillary advancement and 4 mm rotation of the palatal plane downward anteriorly with a 6 mm mandibular setback was planned. The palatal plane was rotated downward to aid in closure of the open bite thereby taking care of the decreased incisal show. Ideal overjet, overbite, satisfactory facial balance and stomato gnathic function could be achieved because of a com­ bined orthosurgical approach.