Pre-surgical And Post-surgical Orthodontic Treatment Of Skeletal â…¢ Malocclusion With Mandibular Shifting

Objective:To discuss orthodontic and orthognathic surgical treatment of ClassⅢskeletal malocclusion with mandibular shifting, providing support in clinical practicefor the study.Method:The case selected was skeletal Class Ⅲ with mandibular shifting inFebruary2012at the Second Affiliated Hospital of Dalian Medical University,Department of Stomatology.The patient was checked with clinical examination,functional checks, model checking symmetry, facial analysis, X-ray measurement andanalysis, after making the diagnosis, orthognathic surgical treatment combinedorthodontic method was designed for the case. Measure treatment outcomedata,compare the data and clinical examination before and after,to analysis the clinicalefficacy of combination therapy.Results:The satisfactory treatment effect was obtained.The jaw bones、the teethand the soft tissue profile significantly improved. The treatment course lasted12monthsin total.In comparison:(1) SNA changed from77°to80°, Po-NaPerp change from3mmto7mm, SNB changed from81°to76°, Co-Gn changed from146mm to130mm, ANBfrom-4°to4°,Wits appraisal from-15mm to-5mm, FMA increased by2°, and ANS-Medecreased by1mm,the length of Co-Go almost the same (2) U1-SN、U1-NA didn’tchang,U1-NA decreased by5mm, however,IMPA increased by5°, this indicated thatthe lingual compensation of the lower incisors due to the increased jaw size wasdecompensated.(3) Soft tissue profile changed towards a more esthetic face followingtreatment, with soft tissue pogonion moving backward and E-line retruding in a clockwise direction.ULP, ULEP increased by2mm, nasolabial anle decrease gently,Zangle from67°to62°,LL-EP decreased by2mm,the front face looks symmetry.Conclusion: Significant improvement can be achieved with orthodontic surgicaltreatment in severe skeletal malocclusion, so that patients can get the ideal appearanceand stable occlusion. Preoperative orthodontic surgery should be based on the ideal goal,to provide adequate preparation; postoperative orthodontic should be related to the jawimmediately after the establishment of good relations and occlusal relationships.Furthermore,to maintain the new positional established jaw and avoid the recurrence.