Orthognathic surgical approach for management of skeletal class II vertical malocclusion

Abstract

The current era of orthodontics has evolved from regular dental corrections to achieve the most needed harmony between functional stability and esthetics enhancement of craniofacial structures. The “desire” for attaining this harmony led to the birth of orthognathic surgeries. The orthognathic approach has undergone a paradigm shift through the years, from correcting the skeletal component to addressing the soft tissues, thus optimizing esthetic outcome. This present case report is of a patient with skeletal Class II malocclusions with vertical maxillary excess (VME), managed by multidisciplinary treatment approach. The treatment progressed through presurgical orthodontics with premolar extraction followed by bi-jaw surgery. The outcome resulted in a phenomenal change in the profile by establishing a Class I skeletal base with a stable occlusion.

Orthodontic Surgical Approach of Severe Skeletal Hyperdivergent Class II Malocclusion Treated by Le-Fort I Osteotomy, BSSO and Genioplasty

“…Due to the amount of underlying skeletaldiscrepancy influenced by the retrognathic mandible andan average lower facial height, it might further reduce the facial height and hence, mandibularadvancement was considered essential for optimalcorrection of the facial profile. To correct the chin deviation and the profileenhancement, horizontal sliding genioplasty was undertaken 7 .…”

“…Due to the reduction in the amount ofmaxillary anterior proclination after the presurgical orthodontic phase, it increased the amountof gingival exposure during the smile which worsened the patient facial profile. However, the motivating factor for the patient was that the facial profile was significantly corrected, and esthetics was enhancedimmediately postsurgery 7,8 . The final treatment outcome washighly successful as the enhancement of facial estheticscombined with well-stable occlusion was established due to the combined orthodonticsurgical approach.…”

Tratamento ortocirúrgico de uma maloclusão classe II esquelética: relato de caso

“…O tratamento ortocirúrgico é indicado rotineiramente para pacientes portadores de maloclusão esquelética Classe II que cessaram o crescimento, com objetivo de alcançar correta relação das bases ósseas, obter oclusão adequada, bem como melhorar a estética facial (1,12). Na abordagem deste caso, a discrepância óssea severa e o crescimento desfavorável foram fundamentais para a determinação do plano de tratamento, cujo objetivo foi reposicionar a maxila e mandíbula vertical e sagitalmente de forma a proporcionar equilíbrio das relações esqueléticas, oclusão excelente e estética facial harmoniosa para o paciente (13).…”

Percepção da função, estética e qualidade de vida em indivíduos com maloclusão classe II em tratamento ortodôntico ou ortodôntico-cirúrgico

“…Representa a discrepância esquelética mais comum que os ortodontistas tratam na prática diária [22]. Nos casos de alterações esqueléticas moderadas ou graves o tratamento ideal é o ortodôntico associado a cirurgia ortognática, para a obtenção de um ótimo equilíbrio esquelético e de tecidos moles [30].…”