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Yao Chen
Yao Chen
Main Instructor Wen Hui Hsieh
Department / Institution Department of Orthodontics / Chunghua Christian Hospital
Classification Case report
In the Classic textbook, Contemporary Orthodontics, William Proffit states that” Orthognathic surgery is indicated in patients whose orthodontic problems are so severe neither growth modification nor camouflage offers a solution.” As a skeletal discrepancy is so severe that it is not possible to camouflage the jaw discrepancy by compensating with tooth movements alone, or the patient’s facial esthetics are severely compromised, orthognathic surgery to reposition the underling basal bone and jaws should be consider  so as to allow for complete correction of the facial esthetics, skeletal discrepancy and dental malocclusion. However, treating implant cases with Class III skeletal discrepancy is actually more critical in consideration of camouflaging since the implants have to locate uprighted over their respective basal bone, which limits the dental compensation other than   nature teeth, and cannot be compromised. This report presents a case of a 20-year-old male with skeletal Class III and high mandibular plane angle. He lost his maxillary four incisors in a car accident and came to ask for reconstruction by implants. According to the patient’s statements, he did not have anterior cross bite or any complaint of occlusion and profile esthetics before trauma. By evaluating the cephalometric analysis, he was supposed to have acceptable Class III dental compensations there were proclined upper anterior and retroclined lower anterior teeth. Although no profile change after treatment was the patient’s preference, he had no choice but to take orthognathic surgery because the previous anterior proclination was not recommended in implant reconstruction.
After presurgical dental decompensation and maxillary anterior implantation, he got an orthognathic surgery to correct malocclusion as well as mild facial asymmetry.
Orthodontic Treatment Combined with Orthognathic Surgery for Class III Malocclusion with Missing of Maxillary Four Incisors-A Case Report