Orthosurgical synergism in the management of severe skeletal Class-III malocclusion- A case report

Abstract

: What is now known as a Class-III malocclusion was initially recognized by Pierre Fauchard. True Class-III malocclusion is a genetically based condition that manifests in childhood. As the youngster reaches the teenage growth spurt, it becomes more obvious. Typically, we will discover a parent or grandparent who is dealing with the same issue. Class-III malocclusion, however, is not a disease. The abnormality itself is a compensatory mechanism to make up for variation that has happened at some point during the course of the individual's development.The case presented here demonstrates the importance of presurgical decompensation, surgical planning, including cephalometric predictions, and mock surgery in the management of severe skeletal Class-III malocclusion. The treatment included comprehensive orthodontic and surgical workup that included bilateral sagittal split osteotomy for mandibular setback of 3mm and LeFort-I osteotomy for maxillary advancement of 3mm. Class-I jaw relationships with a pleasing profile and correctly aligned arches were attained after 2 years of detailed treatment. This led to an aesthetic improvement and a significant increase in the patient's confidence. Class-III skeletal malocclusions can be corrected surgically or through camouflage. However, an ortho-surgical approach may be necessary if the issue cannot be resolved with orthodontics alone. When done correctly, bi-jaw surgery has repeatedly been shown to be quite successful.