Multidisciplinary treatment of complex skeletal class iii malocclusion

Abstract

Introduction. Skeletal malocclusions, especially those with a prominent vertical component, always present a challenge for the interdisciplinary approach to their treatment planning. The aim of this report is to present a patient with a complex skeletal deformity in all three directions (vertical, sagittal and transverse). Case report. A twenty-four year old female patient with a skeletal Class III malocclusion, open bite and laterognathia, was firstly treated by orthodontic fixed appliances, whereas the dental decompensation of dentoalveolar structures was carried out and adjusted to their bone structures, thus enabling an adequate and sufficient reposition of the jaw. A surgical correction included bi-maxillary osteotomy due to pronounced vertical cephalometric parameters, necessitating a posterior maxillary intrusion and mandibular repositioning. In that manner, the relapse was prevented and a long-term stable result obtained. In the retention period, the patient wore removable bi-maxillary retention devices. Conclusion. The combined orthodontic-surgical treatment provided the Class I occlusion with aesthetic and functionally satisfactory results which were envisioned by the treatment plan.