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Clinical Case

Skeletal class III malocclusion, orthodontic-surgical correction, bilateral sagittal osteotomy bilateral subsigmoid, Lefort I and mentoplasty

2017, Volumen 47, Número 2
Sophia Oliveros, Beatriz Gurrola Martínez, Jorge Melgoza y Adán Casasa Araujo
Residente de segundo año. Maestría en Ortodoncia y Ortopedia Maxilofacial. Centro de Estudios Superiores de Ortodoncia. Ciudad de México, México
 

A female patient of 28 years and eight months, who came to the dental office with pre-surgical orthodontics motive. She was a skeletal Class III patient, hyperdivergent, with maxillary hypoplasia, presenting right laterognasia, class III canine and molar, bilateral posterior cross bite to the right side and negative overbite in anterior side, lower midline deviation to the right. Treatment was conducted in three phases: pre-surgical, which included alignment, leveling dental decompensation, occlusal stability; surgical phase, bilateral sagittal osteotomy branch with 4 mm mandibular retrusion, chin surgery (7 mm impaction and chin advancement 3 mm) and maxillary surgery (osteotomy Lefort I, 8 mm of maxillary advancement); post-surgical phase, detailed and retention. All these procedures were with brackets Roth prescription 0.022 × 0.028 6’s and 7’s bands, arcs sequence of Nitinol 0.012-0.016, 0.016 × 0.022, steel arches 0.017 × 0.025, 0.019 × 0.025, surgical rods and resin guide for reference at midline of both arches. In the post-surgical phase detailed bondable tubes were placed in 6’s and 7’s Niti arches and steel 0.017 × 0.025 0.019 × 0.025. Time of treatment: three years and five months. Retention was based on a modified Hawley and circumferential retainer. The result of the treatment was successful, obtaining class I canine and bilateral molars, horizontal and vertical adequate overbite, midlines coincide, correct and a harmonious facial profile, allowing this set of corrections to improve facial aesthetics, and masticatory system functions.  (Rev Esp Ortod. 2017;47(2):098-104)

 
 
Key words:
Asymmetric mandibular prognathism. Maxillary advancement and impaction. Maxillary hypoplasia. Posterior cross bite. Sagittal osteotomy
 
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