71 吳庭祐 / Ting-Yu Wu
Department / Institution Department of Craniofacial Orthodontics, Department of Dentistry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Classification case report
This case report illustrates the use of orthodontic treatment and orthognathic surgery (OGS) approach to treat a patient with traumatic condylar fracture history and congenital skeletal class III deformity. The patient was 20-year-old male suffered traffic accident resulting in right condylar fracture and tooth #42 lost. He had received emergency surgery of open reduction of right condylar fracture and then he visited dental department after ward discharged. He had an anterior open bite and dental class III molar relationship. The cephalometric analysis showed he had mandible prognathism. As function and esthetic concern, patient decided to receive treatment for malocclusion correction and better facial profile achievement. After treatment, ideal overjet and ideal overbite were obtained and the occlusion was stable after OGS. The patient was satisfied with his facial profile.
The patient was diagnosed skeletal class III mandible prognathism with anterior open bite and gummy smile after open reduction of condylar fracture.
We planned two-jaws surgery-first for skeletal deformity correction and orthodontic treatment. The braces were placed without leveling force and OGS was performed right after 6 months of condylar fixation. The OGS was planned by 3D simulation including LeFort I osteotomy, bilateral sagittal split osteotomy and genioplasty. The total orthodontic treatment periods was 18 months. In result, patient obtained balanced facial profile. The #42 missing space was closed by orthodontic treatment and ideal occlusion was achieved.
In this case, we performed OGS after 6 months of condyle fracture repair and the final result showed patient was tolerable to the treatment.
Orthognathic Surgery for Correction of Skeletal Class III Facial Asymmetry After Condylar Fracture: A Case Report