An orthognathic case of skeletal mandibular prognathism with multiple tooth loss

The occlusal collapse caused by multiple tooth loss is a frequent problem found in adult patients with skeletal discrepancies who require orthognathic surgery. In this report, surgical orthodontic treatment was performed on a 38-year-old Japanese female patient with her chief complaint being unable to bite and mandibular protrusion. She presented with skeletal mandibular prognathism, a nearly total crossbite, multiple tooth loss in maxilla and mandible, generalized periodontitis, and an unstable occlusion. In order to re-establish a more stable occlusion we took a multidisciplinary approach including orthognathic surgery, periodontal therapy and prosthetic reconstruction with implants. As a result, the patient’s facial profile was improved and a stable occlusion maintained for three years of retention and two and a half years after the prosthodontics treatment with implant restoration.