When orthodontics makes surgery almost impossible: how to solve the case in acceptable time?

Aim: Orthodontist and surgeon should work in close contact during orthodontic-surgical treatments. Unfortunately, sometimes this does not happen and orthodontics goes in a direction opposite to the ideal one.

An easy and quick solution to these situations is presented.

Materials and methods: A patient with class III skeletal pattern was sent by her orthodontist for surgical correction, nevertheless she had a perfect class I dental occlusion. This happened because the patient was planned to be operated in another center; no real orthodontic plan had been made, so the orthodontist set up by herself a treatment simply to correct the malocclusion.

No surgery was possible at this point, because it would have created a malocclusion.

The patient presented a very concave profile and she was psychologically suffering from it.

The case was treated with anterior mandibular osteotomy for dento-alveolar distraction to create a negative incisal over-jet and to open a one-tooth space between cuspids and 1st premolars. A class III canine malocclusion was created in accordance with the existing skeletal situation.

Results: Now, a bimaxillary osteotomy was performed with occlusal clockwise rotation. Two dental implants were inserted in the distraction spaces, so she had three premolars in each side of the mandibular arch.

Finally the patient had class I canine and class II molar relationship. Occlusal and skeletal-aesthetic result was satisfactory.

Conclusions: Following this method, the frontal dento-alveolar distraction osteogenesis technique was carried out in the pre-surgical orthodontic treatment every time that a severe dento-basal discrepancy was present.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on When orthodontics makes surgery almost impossible: how to solve the case in acceptable time?
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