교정적 절충 치료를 받은 III급 부정교합 성인 환자의 악교정 수술을 동반한 재교정 치료

Re-Orthodontic Treatment Combined with Orthognathic Surgery in an Adult Class III Malocclusion Patient Undergone Camouflage Orthodontic Treatment

In order to improve the incisal angle and occlusal plane of the maxilla without tooth extraction, maxillary rotation, which makes the maxillary occlusal surface move forward and downward, can be applied to increase mandibular set-back and de-crease the vertical dimension of the skeletal Class III. Therefore, if an appropriate surgical occlusion is formed through min-imal pre-surgical orthodontic treatment, there will be an advantage of quick operation and short treatment period. A female patient who had a history of growth modification and orthodontic treatment decided to have orthodontic retreatment with orthognathic surgery due to aesthetic problems and open bite relapse. For 6 months of presurgical orthodontic treatment, the inclination of the maxillary molars was adjusted using a full-size stainless-steel wire, and the intermolar width problem was corrected by adjusting the lingual inclination of the mandibular molars using Schwarz’s appliance with a posterior bite block. Additionally, adjustment for occlusal interferences of the maxillary palatal cusps was continuously performed. The patient had LeFort I osteotomy with PNS impaction, mandibular setback, and additional genioplasty. As a result, the overall length of the face was reduced and asymmetry was corrected, resulting in a stable Class I occlusion relationship. In order to shorten the presurgical orthodontic period, minimal presurgical orthodontic treatment was done without extraction, and appropri-ate mandibular set-back results were obtained by adjusting the maxillary incisor angle and occlusal plane through maxillary rotation.