IVRO? SSRO? Skeletal Class III Malocclusion?

 


The basic objectives of orthodontics and orthognathic surgery are to meet patient' complaints, establish optimal functional outcomes, and promote good esthetic results. To achieve this, the orthodontist and the surgeon must be able to correctly diagnose dental and skeletal deformities and establish an appropriate treatment plan for that patient. Class III malocclusion is a difficult anomaly to understand.

 



There are three main treatment options for skeletal Class III malocclusion: growth modification, dentoalveolar compensation, and orthognathic surgery. Growth modification should be initiated before the pubertal growth spurt; afterwards, only two options are possible. Thus, treatment of skeletal Class III malocclusion in an adult requires orthognathic surgery combined with conventional orthodontic treatment aiming to improve self-esteem and achieve normal occlusion and improvement of facial esthetics.

 


Surgical treatment of Class III malocclusion includes, in most cases, mandibular retrusion, maxillary protrusion, or a combination of both. Mandibular clockwise rotation can also provide the same result as mandibular retrusion, when increase of lower anterior face height is allowed. Although the problem appeared to be a protruded mandible, the orthognathic surgery included a counterclockwise rotation of the mandibular occlusal plane with advancement of pogonion, segmentation of the maxilla with advancement and expansion, and surgical protrusion of the chin. The pros and cons of these procedures are discussed.

 

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