Oral rehabilitation approach in skeletal class III malocclusion with orthognathic surgery, an interdisciplinary case report.

Abstract

Introduction: The limitations of growth modification often advise adult patients to undergo orthognathic surgery to achieve optimal oral rehabilitation. This report aims to provide an in-depth description of the well-coordinated orthodontic and orthognatic surgery treatment of an adult with skeletal Class III malocclusion.

Case presentation: A 37-year-old male patient presented with a complaint of chronic pain in the temporomandibular joint associated with mandibular protrusion. Clinical and radiological examinations revealed Class III skeletal relationships related to mandibular prognathia (ANB angle of -6.85°), Class III molar and canine relationships, a decrease in the lower one-third of face height, a protruded lower lip, and dark buccal corridors in the smile.

Discussion: Preoperative orthodontic decompensation determines the discrepancy and maximizes mandible repositioning. The technique improves surgical planning and therapy outcomes. This case report describes the "Hunsuck modification fracture pattern," which is a type of fracture that has a horizontal cut behind the lingula and a vertical line on the lower edge of the jaw that connects to the outer cut of the jaw. Because the fracture line does not damage the neurovascular bundle or the posterior edge of the ramus, this setup provides the best stability and promotes osteotomized segment recovery.

Conclusion: The interdisciplinary management of severe skeletal Class III malocclusion with ortho-surgical intervention effectively corrects anteroposterior jaw discrepancies. Orthognathic surgery was the most effective option for achieving acceptable occlusion and an aesthetically pleasing result in this patient.