“Surgery-first Orthognathic Approach” for Correction of Skeletal Class III with Open Bite

Abstract

This case report illustrates the treatment of a skeletal class III patient with the surgery-first orthognathic approach (SFOA) protocol. “Surgery-first orthognathic approach” is a growing trend that provides an immediate facial change. The SFOA protocol utilizes dentoalveolar compensation as the key advantage to effect immediate facial change, which in conjunction with the rapid acceleratory phenomenon (RAP) augments the intended tooth movement, thereby reducing the total treatment duration. A 24-year-old male presented with forwardly placed lower jaw with associated difficulty during eating. Clinical examination revealed severe lip incompetency, mandibular excess, class III skeletal malocclusion, severe bimaxillary incisor proclination, posterior crossbite, and lower midline shift toward right on an average mandibular plane angle. The SFOA protocol involving bilateral sagittal split osteotomy (BSSO) mandibular setback along with the correction of the pitch and yaw was performed and the orthodontic phase was followed. The total treatment time was 5 months and 15 days, following which excellent facial transformation and stable occlusion was achieved. Divakar RR, Parameswaran R, Jayapal J, et al. “Surgery-first Orthognathic Approach” for Correction of Skeletal Class III with Open Bite. J Contemp Dent 2019;9(3):144–149.