Esthetic and occlusal rehabilitation of Class III malocclusions. An alternative approach.

Abstract

Restorative correction of a moderate to severe malocclusion puts both the dentist and patient at a higher subjective risk regarding biologic and occlusal parameters. Without the use of orthodontics or orthognathic surgery, the prosthodontic demands on misaligned abutments can be significant. However, the use of logical force management concepts can deliver a biomechanically stable result. Some of these include accurately recording a repeatable condyle position, distributing non-axial occlusal forces evenly, adding length and buccal volume in a 1:1 ratio, and testing the new occlusal scheme for a considerable time before finalization. The present case report describes an alternative treatment route to rehabilitate a patient who declined orthodontic therapy after several specialist consultations. In summary, our expedition involved orthopedic repositioning of the condyles into an airway centric relation, increase in the vertical dimension of occlusion, autorotation of the mandible, buccalization of the maxillary arch, lingualization of the mandibular arch, dentoalveolar decompensation, diastemata closure, and prosthetic soft tissue camouflage.