Orthodontic-surgical treatment of the skeletal class III malocclusion: A case report

Abstract

Background. Class III malocclusions are considered to be ones of the most difficult problems to treat. Their causes are multifactorial and include genetic and/or environmental factors. Class III malocclusions are generally classified into 2 categories: skeletal and dental. The diagnosis is important due to the different treatment approaches. Generally a dental class III can be treated with orthodontics alone, while a true skeletal class III requires a combination of orthodontics and surgery. Case report. We presented a female patient with skeletal Class III malocclusion. The treatment was complete with positive overbite and acceptable occlusion using a combination of fixed orthodontic appliance treatment as well as the surgical operation. The patient was happy with her new appearance and function. Conclusion. Class III discrepancy should be diagnosed and classified according to its etiology and treated with appropriate surgery, including, if necessary, not only mandibular, but also maxillary surgery, in order to achieve a normal facial appearance. In any case, as the field of orthodontics continues to develop technologically and philosophically, we can expect that advances in diagnosis and treatment planning are imminent and inevitable.

Uvod. Malokluzije III klase smatraju se među najtežim za lečenje. Faktori koji dovode do njihovog formiranja su različiti, počev od naslednih do onih koji se javljaju tek posle rođenja. Ove malokluzije se inače dele na dve velike grupe: dentoalveolarne i skeletne. Zbog različitih pristupa samom lečenju kako dentoalveolarnih, tako i skeletnih oblika ove malokluzije, najvažnije je postaviti tačnu dijagnozu. Dentoalveolarni oblici III klase mogu se lečiti samo ortodontski, dok teži slučajevi skeletnih oblika moraju da kombinuju ortodontsko-hirurško lečenje. Prikaz slučaja. U ovom radu prikazana je bolesnica sa malolkuzijom III skeletne klase. Lečenje je završeno sa pozitivnim zadovoljavajućim preklopom i okluzijom ortodontskim prehirurškim lečenjem, kao i hirurškim zahvatom. Bolesnica je bila zadovoljna novim promenama kako intraoralnim, tako i ekstraoralnim, uočljivim na samom licu kao i postignutom funkcijom. Zaključak. Mimoilaženje vilica III klase neophodno je dijagnostikovati i svrstati prema poreklu i uzroku i lečiti primenom odgovarajuće hirurgije uključujući, prema potrebi, ne samo hirurgiju mandibule, već i maksile. U svakom slučaju, možemo očekivati stalno usavršavanje u postavljanju dijagnoze i lečenju s obzirom na činjenicu da se ortodoncija razvija i tehnološki i filozofski.