Surgical-orthodontic Treatment of a Patient with Severe Skeletal Class III Anterior Open Bite and High Mandibular Plane by Preserving the Posterior Facial Height

Surgical-orthodontic Treatment of a Patient with Severe Skeletal Class III Anterior Open Bite and High Mandibular Plane by Preserving the Posterior Facial Height

Class III malocclusions with a hyperdivergent vertical facial pattern are often difficult to treat without combining the surgical-orthodontic approach. The aim of this article is to present a collaborative management of a case with severe skeletal class III and anterior open bite. The 19-year-old man was characterized with midface deficiency, mandibular prognathism, high mandibular plane angle, long lower facial height, and excessive anterior open bite. The achievement of a stable surgical setup in interdigitation prior to orthognathic surgery (OGS) is critical for a successful treatment via dental decompensation. Two-jaw surgery with clockwise rotation of the maxilla and bilateral sagittal split osteotomies was performed to correct the skeletal Class III malocclusion and anterior open bite. An acceptable smile arc and facial profile were achieved. The total treatment duration was 28 months. The treatment outcome presented a good facial profile and solid occlusion. Moreover, the skeletal and dental relationships were stable 2 years after finish. Accurate diagnosis and treatment design, good patient's compliance, and effective communication are essential to correct the severe dentoskeletal deformaties.