Correction of Skeletal Class III Malocclusion with Four Missing Premolars by Surgery-First Approach

Correction of Skeletal Class III Malocclusion with Four Missing Premolars by Surgery-First Approach

A 21-year-old female with severe concave profile and prominent chin came for surgical-orthodontic consultation. The patient had missing of four premolars which became intricate with extremely lingual inclined incisors and over-developed mandible. The surgery first approach (SFA) was adopted to correct the skeletal factors at the early stage. The preadjusted orthodontic bracket system was applied to normalize the torque of the teeth afterward. The capacities of anterior root-torquing auxiliary wire (ART) and multiple-loop edgewise archwire (MEAW) will be discussed, accordingly. The progress records showed remarkable improvement of profile and occlusion. The change of upper incisor show was also discussed. The 3 years follow-up records further demonstrated good stability of the treatment outcome.