• The Journal of the Korean dental association
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• v.50 no.2
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• pp.64-71
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• 2012

Recently, the presurgical orthodontic duration tends to be shortened by virtue of the advancement of surgical and orthodontic techniques in class III orthognathic surgery cases. But the predictability of the surgical results should be secured by removing several uncertain factors in presurgical orthodontic treatment. The purpose of this study is to investigate the influence of immediate postsurgical occlusal stability on postsurgical mandibular change. The study includes 40 patients who underwent orthognathic surgery to correct skeletal class III malocclusion. The patients were divided into two groups based on the numbers of occlusal contact in surgical setup occlusion: group 1 (stable surgical occlusion, n=24) and group 2(unstable surgical occlusion, n=16). Changes of horizontal and vertical mandibular measurements during postsurgical follow up period(from 1 week postsurgery to 12month after debonding) were compared to examine the differences between two groups. The stability of surgical occlusion is one of the factors influencing postsurgical mandibular changes in class III malocclusion. The various class III malocclusion cases have specific prerequisites for the orthognathic surgery according to the skeletal patterns. The prerequisites should be obtained by minimum presurgical orthodontics to increase the predictability of the surgical results.

• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.23-34
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• 2005

Collective changes caused by orthodontic tooth movement evaluated in a specific treatment modality could give suggestive information on the specific treatment strategy. The aim of this study was to investigate retrospectively the characteristics of the orthodontic tooth movement during surgical-orthodontic treatment in order to provide an effective presurgical orthodontic treatment planning for the maxillary premolar extraction modality In the skeletal Class III malocclusion patient. Pre- and post-treatment dental casts of skeletal Class III malocclusion patients with nonextraction (N=:24) and the maxillary premolar extraction (N=31) were collected. The angulation and inclination measuring gauge(Invisitech Co. Seoul, Korea) was used to evaluate the orthodontic tooth movement. The changes in the maxillary and mandibular dental arch widths were also measured from the canines to the second molars. As a result, more palatal inclination change in the maxillary dentition was found with the premolar extraction modality than with the nonextraction modality. Linear regression analysis showed that the inter-arch width coordination was mainly due to the inclination changes of maxillary posterior teeth We conclude that the indications and proper treatment planning for surgical-orthodontic treatment in skeletal Class III malocclusion with maxillary premolar extraction could depend partly on the magnitude of the transverse inter-arch coordination especially in the maxillary dentition.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.174-183
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• 2000

This study was performed to investigate the characteristics of soft tissue profile of the class III malocclusion and to test the yardstick far differential diagnosis between surgical and orthodontic patients. Initial lateral cephalograms of orthodontic group(30 patients) that have acceptable occlusion and profile by orthodontic treatment alone and surgical group(30 patients) that have favorable occlusion and profile by combined surgical-orthodontic treatment were selected in Ajou university hospital. Powell and Burstone II analysis were made on the tracing. Descriptive, comparative, factor, cluster, and discriminant analysis were carried out with computer program. The results were as followings : 1. Patients who received surgery had a more concave profile and a longer lower facial height than patients who received orthodontic treatment alone. 2. Nasolabial angle, ratio of vertical height, and mentolabial sulcus were significantly different at the 5% level. And facial protuberance, upper lip protuberance, mentocervical angle, nasofrontal angle, nasomental angle, mandibular vertical height, angle between cervix and lower face, ratio of mandibular vertical height divided by cervical depth, ratio of vertical height between upper and lower lip, and maxillary protuberance were significantly different at the 1% level. 3. 8 factors were extracted and factor 2, 3, and 8 showed significant differences by factor analysis. 4. Orthodontic group (25) and surgical group (35) were classified by cluster analysis. 5. Discriminant function was D = 0.079Nasomental angle + 0.081Sn-Gn + 3.343Sn-Gn/C-Gn + 1.734Sn-St/St-Me' -26.460, and cutting score was 0, so we can discriminate that orthodontic group has the score above 0, and surgery group below 0. And 91.7% of original grouped cases were correctly classified.

• The korean journal of orthodontics
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• v.38 no.1
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• pp.60-67
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• 2008

Treatment of adult patients with Class III malocclusion frequently requires a combined orthodontic and surgical approach. However, if for various reasons, nonsurgical orthodontic treatment is chosen, a stable outcome requires careful consideration of the patient's biologic limitation. This case presents the orthodontic treatment of an adult with a Class III malocclusion, which was treated nonsurgically using indirect skeletal anchorage.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.349-357
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• 2010

Physical factors and intra- and extra-oral factors of a patient have to be considered in order to decide a treatment plan for the skeletal class III malocclusion patient. Most of cases, the pre-prosthodontic treatment requires the orthodontic approaches and maxillofacial surgery. However, in some cases, patients' economic or medical condition makes impracticable situation for the orthodontic or surgical intervention. For those cases, the compromised prosthetic treatment which provides more stable and persistent occlusal stabilization is recommended. In this case report, a woman patient has a skeletal class III maxillomandibular relationship and misses multiple teeth. The prosthetic treatment without orthodontic and surgical intervention is performed due to her physical problem. The functional and esthetic results are achieved by the fixed prosthesis.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.479-486
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• 1998

Bimaxillary Protrusion can be treated effectively in growing patients and in adults with conventional orthodontic therapy. However, In the adult patient, combined surgical and orthodontic treatment modalities may offer distinct advantages over such conventional therapy. In those cases complicate by vertical jaw dysplasia, sagittal dysplasia, or transverse skeletal discrepancy in addition to bimaxillary protrusion, the possibilities of obtaining successful results through orthodontic treatment alone greatly diminish. Surgical retraction of both maxillary and mandibular anterior segments with subapical osteotomies and ostectomies in the extraction site may be a good treatment alternative. Treatment time and possible adverse effects of lengthy orthodontic therapy may be reduced and optimum esthetic improvement may be facilitated. On the following cases, patient who had bimaxillary protrusion with Angle class III malocclusion was treated with combined orthodontic - surgical therapy by anterior subapical segmental osteotomies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.6
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• pp.559-565
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• 2006

The aim of this study was to evaluate the amount and interrelationship of the soft and hard tissue changes after simultaneous maxillary clockwise rotation and mandibular setback surgery in skeletal class III malocclusion. The sample comprised of 16 adult patients who had anteroposterior skeletal discrepancy. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of Le fort I Osteotomy and bilateral saggital split ramus osteotomy. The presurgical (T1) and postsurgical (T2) lateral cephalograms were evaluated. The computerized statistical analysis was carried out with SPSS/PC program. The results demonstrated a decrease in the vertical dimension in the soft and hard tissue. The nasolabial angle was increased and the mentolabial angle was decreased. The results showed also many statistically significant correlations(p<0.05). The lower lip closely followed the skeletal movement of the B- point in the horizontal plane. The double jaw rotation surgery can afford a good solution to solve the problems of class III malocclusion cases.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.407-412
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• 2011

Purpose: The purpose of the present study was to evaluate the postoperative skeletal stability of two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) via surgery first orthodontic treatment (SFOT) in class III malocclusion. Methods: Thirty-two patients who had two-jaw surgery via SFOT were included in this study. Serial lateral cephalograms were obtained before (T0), immediately after (T1), and six months after (T2) surgery. Twelve variables were measured for horizontal and vertical skeletal stability as well as for dental change. All measurements were evaluated statistically by a paired t-test ($P$ <0.05). Results: The mean skeletal changes were $0.1{\pm}2.5$ mm at point A and $-12.0{\pm}7.4$ mm at the pogonion. The mean horizontal relapse was 11.6% at the pogonion, and the mean vertical surgical changes included an upward displacement of $2.1{\pm}7.1$ mm and a forward displacement of $1.4{\pm}4.6$ mm at the pogonion. Upper incisor inclination decreased after surgery and was maintained at T2, and lower incisors were proclined from T1 to T2 by postsurgical orthodontic treatment. Conclusion: Postoperative skeletal stability of two-jaw surgery via surgery first orthodontic treatment in class III malocclusion was clinically acceptable.

• The korean journal of orthodontics
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• v.46 no.1
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• pp.42-54
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• 2016

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.304-313
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• 2020

Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.