Main Instructor Fang-Chin Chen
Department / Institution Orthodontic section, Department of Stomatology, Veterans General Hospital, Taipei, Taiwan
Classification Case report
There is higher prevalence of skeletal Class III malocclusion in Asian population, and which is frequently associated with facial asymmetry. In severe mandible prognathism with facial asymmetry cases, the outcomes and long-term stability should be considered when we discuss treatment plan and surgical technique with oral surgeon.
This is a 18 years old male case with class III skeletal pattern (ANB=-9°), normal angle, and skeletal menton point was deviated to L’t 7.5mm. Intraorally, negative overjet (-6.5mm) and asymmetric molar relationship (R’t Class III / L’t Class I) were noted.
Our treatment goal was to correct mandible prognathism and facial asymmetry combined with orthognathic surgery. Upper premolars were extracted for crowding relieving. After presurgical dental decompensation and arch coordination, the bilateral Intraoral vertical ramus osteotomy (IVRO) was performed. Mandible was setback up to 15mm, however, post-surgery relapse was limited. Total treatment time was 36 months.
Long term stability of orthognathic surgery is still challenging for orthodontist and oral surgeon. We should consider these potential factors in order to prevent the relapse. In this case, there is great improvement with acceptable stability. The detailed progress, three-dimensional evaluation of treatment outcomes and consideration of stability will be illustrated in this case report.
The Surgical-Orthodontic Treatment of Severe Skeletal Class III with Facial Asymmetry- A Case Report