Non-Surgical Orthodontic Treatment of an Orthognathic Surgical Case

Treatment planning decisions that involve surgical intervention to realign the maxilla and mandible or to reposition dentoalveolar segments in cases of severe malocclusion associated with maxillary retrusion or deficiency and mandibular prognathism are based on the degree of discrepancy and performance limits of conventional orthodontic systems [1]. Clinical presentation of these skeletal and dental asymmetries are considered some of the most complex and difficult to treat and are often most classified as Angle’s Class III [2]. Newer and biologically based diagnostic terminology for this condition is mandibular orthodontosis [3]. Patients typically exhibit a prominent lower third of the face which is accompanied by a concave facial profile with a lower lip that is protrusive relative to the upper lip [4]. While the contribution of oral function and environmental factors are not completely understood, this condition does exhibit a genetic predisposition tendency [5-7]. Proper diagnosis of the skeletal case is challenging and requires careful treatment planning. While the patient’s chief complaint is most often associated with a poor facial appearance it may be accompanied by functional and temporomandibular problems [8].