Dental and Medical Problems

Dent Med Probl
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Dental and Medical Problems

2020, vol. 57, nr 1, January-March, p. 103–109

doi: 10.17219/dmp/112574

Publication type: clinical case

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Complex orthodontic and surgical management of an adult patient with transverse maxillary deficiency and skeletal class III malocclusion: A case report

Kompleksowe leczenie ortodontyczno-chirurgiczne pacjentki dorosłej z niedorozwojem poprzecznym szczęki i III klasą szkieletową – opis przypadku

Rafał Nowak1,A,B,C,D,E,F, Małgorzata Rzepecka-Skupień2,B,C,D, Ewa Zawiślak2,C,D,E

1 Department of Maxillofacial Surgery, Wroclaw Medical University, Poland

2 Department of Maxillofacial Orthopedics and Orthodontics, Wroclaw Medical University, Poland

Abstract

Skeletal deformities constitute a relatively common structural and functional craniofacial abnormality. The chief complaints reported by patients include a lack of satisfaction with facial appearance, difficulty with breathing or eating, and altered speech. The management of skeletal malocclusion requires a complex orthodontic and surgical approach. The paper presents the case of a 28-year-old woman with maxillary constriction and skeletal class III malocclusion. Transpalatal distraction (TPD), based on the distraction osteogenesis phenomenon, was used for correcting transverse maxillary deficiency by increasing the maxillary bone base, and therefore the transverse maxillary dimension. The next stage was orthodontic treatment, involving dentoalveolar decompensation, as part of preparation for bimaxillary osteotomy (BIMAX). The last stage of the complex treatment was BIMAX, which ultimately eliminated skeletal defects in both the sagittal and frontal planes. This complex multidisciplinary management significantly improved facial harmony, increased nasal volume, caused a shift from mouth breathing to nasal breathing, and restored normal occlusal relationships.

Key words

orthognathic surgery, orthodontics, skeletal maxillary constriction, skeletal deformities

Słowa kluczowe

chirurgia ortognatyczna, ortodoncja, zwężenie szczęki, wady gnatyczne

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