Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.22
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
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Dental and Medical Problems

2016, vol. 53, nr 3, July-September, p. 424–429

doi: 10.17219/dmp/63536

Publication type: clinical case

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Combined Orthodontic and Surgical Treatment of Skeletal Class III Malocclusion: A Case Report

Zespołowe leczenie ortodontyczno-chirurgiczne szkieletowej klasy III – opis przypadku

Patrycja Downarowicz1,A,B,C,D,F, Beata Kawala2,E,F, Rafał Nowak3,A,E,F

1 Department of Maxillofacial Orthopaedics and Orthodontics, Department of Facial Abnormalities, Wroclaw Medical University, Wrocław, Poland

2 Department of Maxillofacial Orthopaedics and Orthodontics, Division of Maxillofacial Orthopaedics and Orthodontics, Wroclaw Medical University, Wrocław, Poland

3 Department of Maxillofacial Surgery, Wroclaw Medical University, Wrocław, Poland


Skeletal class III malocclusion can be caused by excessive mandibular growth, maxillary hypoplasia, or a combination of both. The aim of this study was to present a multidisciplinary treatment of a 28 year-old female with a skeletal class III malocclusion and bilateral hypodontia of the first and second maxillary premolars. Orthodontic treatment, as a part of the patient’s preparation for surgery, included a straight wire appliance using Roth prescription for both dental arches. A transpalatal distractor (TPD) was used to correct the transversal maxillary deficiency. The expansion was later continued using the quad-helix appliance. The second stage of surgical management included the bimaxillary osteotomy (BIMAX) in order to correct the skeletal malocclusion (mandibular prognathism and maxillary hypoplasia). Orthodontic treatment was continued after surgery, until the normal occlusal relationships were restored. The outcomes included a complete functional repair of the patient’s stomatognathic system and a significant improvement of the aesthetic appearance of her face. Multidisciplinary management was used involving orthodontic and surgical strategies. The treatment restored normal occlusal relationships, improved the stomathognatic function, the patency of upper airways as well as the aesthetic appearance of the patient’s face and smile.

Key words

orthognathic surgery, severe maxillary hypoplasia, transversal maxillary distraction

Słowa kluczowe

chirurgia ortognatyczna, rozległa hipoplazja szczęki, poprzeczna dystrakcja szczęki

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