Interdisciplinary Orthodontic and Surgical Management of Class III Malocclusion in Adult Patients - Interdisciplinary Orthodontic and Surgical Management of Class III Malocclusion in Adult Patients - Open Access Pub

The treatment of class III malocclusion differs depending on the age of the patient. In adult patients, alternatives include either orthodontic dentoalveolar compensation treatment or a combined ortho-surgical approach. The aim of this paper is to present the orthodontic and surgical treatment of a 24 year old adult patient with increased anterior face height, a class III skeletal pattern and mandibular asymetry. Previous orthodontic treatment with removable appliances obtained a 1 mm overbite and overjet. Intraorally, class III molar relationship was observed, proclined upper incisors, retroclined lower incisors and a deviated lower midline. The main complaint was facial esthetics which required surgical intevention. After pre-surgical orthodontic preparation the maxilla was repositioned by a Le Fort I osteotomy and the mandible was set back using the Obwegeser-Dal Pont method. Final assesment revealed both functional and esthetic dentofacial results. A combination of orthodontic treatment and orthognathic surgery is often required in adult patients with dental malocclusion and skeletal discrepancies. DOI10.14302/issn.2473-1005.jdoi-19-3042 Class III malocclusion is a challenge to the orthodontic profession representing a complex skeletal imbalance between upper and lower jaw growth patterns accompanied by various dentoalveolar and soft tissue compensations.1 Given the complexity of the malocclusion three treatment options are available: growth modification, orthodontic camouflage and surgical treatment. Timing of growth modification treatment is important and can only take place before the pubertal growth spurt.2 Thus for adult patients, two alternatives remain: dentoalveolar compensation or a combination of orthodontic treatment and orthognathic surgery. When facial esthetics are compromised, orthodontic treatment might not be enough to meet the complaints of the patient. In order to provide esthetic, functional and stable results, the orthodontist and the surgeon must collaborate during the diagnosis stage so that a detailed treatment plan for the patient is reached. 3 Class III are mainly characterized by sagital skeletal discrepancies: mandibular prognathism, maxillary retrognathism or both.3, 4 Dental discrepancies include class III Angle molar relation and anterior crossbite, often with an increased negative overjet. The specific facial profile of the patient is prognathic, with a proeminent chin, which is considered both an esthetic and psychological problem and is a major reason why many adult patients choose a surgical correction. 4, 5, 6 The