성장기 때 절충교정치료 경험이 있는 골격성 III급 부정교합 환자의 수술 교정 치험례

Surgical Orthodontic Treatment of Hyperdivergent Skeletal Class III Malocclusion Patient Experienced in Camouflaging Orthodontic Treatment: Case Report

The purpose of this case report is to describe the considerations in orthodontic treatment and orthognathic surgery in a patient with skeletal Class III malocclusion that had camouflage orthodontic treatment. A patient who had camouflage orthodontic treatment with four 1st premolars extraction showed hyperdivergent skeletal Class III malocclusion and asymmetry. Open coil springs were used to regain the extraction space of the mandibular first premolars and decompensate lower anterior teeth, and a criss-cross elastics was used to upright the lower right molars for posterior decompensation. Le Fort I and midpalatal segmental osteotomy were performed to achieve total impaction (2 mm), forward movement (2 mm) and expansion (3 mm) of the maxilla. Bilateral sagittal segmental osteotomy (BSSRO) was performed to achieve asymmetric set back of the mandible (right: 6 mm, left: 10 mm). The asymmetric and protruded mandible was corrected after orthognathic surgery and orthodontic treatment, resulting in an aesthetic facial appearance, and ideal overjet and overbite. After 1 year of orthodontic treatment, stable occlusal relationship, appropriate overjet and overbite were observed.