COMBINED ORTHODONTIC AND SURGICAL TREATMEN IN PATIENT WITH MANDIBULAR PROGNATHISM

Abstract

The aim of this case was to present a combined orthodontic-surgical treatment for a 30-year-old patient. The initial clinical examination revealed a Class III malocclusion, concave profile, 4.5mm overjet, and 2mm overbite. The treatment plan included orthodontic preparation with fixed appliances, surgical correction of skeletal discrepancies, and post-surgical orthodontic treatment. Lateral cephalograms were taken before the orthodontic therapy, just before the surgical intervention, and after the treatment, following the removal of fixed appliances. On the initial lateral cephalogram SNB angle was 88°, ANB -5°, SpP/MP 28°, total Bjork’s polygon angle 405°, I/SpP 71°, i/MP 111° and mandibular corpus length was increased by +11mm. On the final post-surgical lateral cephalogram, after the intervention and appliance removal the SNB angle was 81°, ANB 3°, SpP/MP 25°, total Bjork’s polygon angle 398°, I/SpP 64°, i/MP 96° and man- dibular corpus length was increased by +3mm. The pre-surgical orthodontic treatment lasted 12 months, followed by bimaxillary surgery. The post-surgical orthodontic treatment lasted 12 months. After appliance removal, a retentive phase with night-time wear of retainers was implemented. The result was stable Class I occlusion, satisfactory profile appearance, 2.5mm overbite, and 2mm overjet.