Abstract

Abstract Dental implants placed in the maxillary anterior region have a high risk of aesthetic complications caused by later infra-occlusion and may subsequently require special therapeutic considerations to achieve optimal aesthetic and functional results. Based on the severity, possible treatment options for infra-occluded implants include replacement of the implant restoration, alveolar distraction osteogenesis, repositioning by a segmental osteotomy, or the removal of the implant. The present case report describes the successful application of bi-maxillary orthognathic surgery combined with an anterior segmental osteotomy for the correction of a Class III open-bite malocclusion complicated by severely infra-occluded implants.

Highlights

  • There has been an increase in the number of adult orthodontic patients, many of whom have dental implants for the replacement of missing teeth

  • The present case report describes bi-maxillary orthognathic surgery combined with an anterior segmental osteotomy for the correction of a Class III open-bite malocclusion complicated by severely infra-occluded implants

  • The present case described a male patient who presented with a Class III anterior open-bite malocclusion that was treated by bi-maxillary orthognathic surgery, including an anterior segmental osteotomy to reposition infra-occluded upper anterior implants

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Summary

Introduction

There has been an increase in the number of adult orthodontic patients, many of whom have dental implants for the replacement of missing teeth. Accompanying the increase in implant usage, consequential orthodontic problems have arisen, one of which is a positional discrepancy between an implant and the adjacent teeth due to early implant placement in a patient whose growth was incomplete. Anterior implants placed during the late adolescent period are especially prone to later functional and aesthetic problems. Implants do not follow the vertical growth pattern of the alveolar process, and when implants infra-occlude, a vertical alveolar bone discrepancy, and a gingival margin discrepancy are unwelcome complications.[1] When treating presenting patients, strategic orthodontic planning as well as surgical treatment options should be considered. Depending on the severity of the infra-occluded implants and the desired final

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