Main Instructor Ting-Yu Wu
Department / Institution Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Classification Case report
Anterior open bite is one of the most difficult dentofacial deformities to treat, especially in Class III malocclusion. The correction of skeletal Class III malocclusion with anterior open bite often combines orthodontic and orthognathic treatment. This case report describes a surgery-first approach to a patient with Class III, anterior open bite, and bilateral posterior crossbite.
This 18-year-old male complained about difficulty in chewing. Skeletal Class III malocclusion with hyperdiverdent facial pattern was diagnosed. Intraoral examination presented anterior open bite and bilateral posterior crossbite. A surgery-first approach including bilateral intraoral vertical ramus osteotomy (IVRO) was performed to achieve setback and counterclockwise rotation of the mandible. After surgery, full-mouth fixed edgewise appliance, bone screws, and elastics were used. After 22 months of treatment, acceptable overjet and overbite were achieved; facial profile and occlusion were also improved.
Surgical-orthodintic treatment has been widely used in patient having severe posterior or transverse discrepancy. The surgery-first approach has several advantages. In this case, this approach was chosen to correct anterior open bite and reverse overjet to enhance patient’s chewing function and facial appearance soon after surgery. However, the limitations of this approach should be considered. Experienced surgeons and orthodontists lead to a successful treatment.
A Surgical First Approach to Skeletal Class III with Anterior Openbite- A Case Report