Surgical-orthodontic retreatment of a severe skeletal Class III malocclusion following an orthodontic camouflage

ABSTRACT Introduction: Class III malocclusions are some of the most difficult occlusal anomalies to be treated. Some patients with this condition may require orthognathic surgery, while others may be treated with dental camouflage. Proper patient assessment and selection remains critical in order to achieve favorable results. Objectives: This report outlines the case of an 18-year-old male who sought retreatment for a severe skeletal Class III dentofacial deformity after undergoing orthodontic camouflage treatment involving mandibular arch extractions. A treatment plan comprising dental decompensation and orthognathic surgery was implemented in order to achieve optimal facial and occlusal results. Results: After 28 months of treatment, skeletal and dental correction was achieved and facial features were significantly improved. The orthognathic surgery required a 20-mm sagittal maxillomandibular skeletal correction, combined with a 4-mm correction of the midlines and a 2-mm impaction of the maxilla. Conclusion: Dental compensation may be a risky treatment alternative for severe dentoskeletal discrepancies. In these patients, orthodontics combined with orthognathic surgery is the recommended treatment option.

摘要：引言：III类错颌畸形是治疗难度较大的牙合畸形之一。部分患有此类症状的患者可能需要正颌外科手术，而另一些患者则可能通过牙齿掩饰治疗。为取得理想的治疗效果，对患者进行恰当的评估与选择至关重要。目标：本报告详细描述了一位18岁男性患者的病例，该患者在经过涉及下颌弓提取的正畸掩饰治疗后，因严重骨骼III类牙面畸形寻求再次治疗。为了实现最佳的面部与牙合效果，实施了包括牙齿代偿与正颌外科手术的治疗方案。结果：经过28个月的治疗，实现了骨骼和牙齿的矫正，面部特征显著改善。正颌外科手术需要进行20毫米的矢状面上下颌骨骨骼矫正，结合中线4毫米的调整以及上颌2毫米的嵌入。结论：牙齿代偿可能是一种风险较高的治疗方法，用于严重的牙骨不匹配。在这些患者中，正畸与正颌外科手术的结合是推荐的治疗方案。