Orthodontic-surgical treatment of a severe class III malocclusion

• Main Author: Pakpahan Evie Lamtiur (Author)
• Format: Book
• Published: Universitas Airlangga, 2013-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<p><em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-variant: normal;"><strong>Background: </strong><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">Adult patient with dentofacial deformities usually need surgical orthodontic treatment. Although case of class II <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">dentofacial deformities are more common, the need for treatment and improvement in term of facial profile is generally greater in class <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">III patients. When a skeletal Class III malocclusion is diagnosed, orthognathic surgery is always considered if the orthodontist and <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">patient desire complete correction of the skeletal discrepancy. <span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-variant: normal;"><strong>Purpose: </strong><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">The purpose of this article were to reported a case of severe <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">class III malocclusion and to showed the positive effect of orthognatic surgical treatment on the patient's profile. <span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-variant: normal;"><strong>Case: </strong><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">This case report <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">describes the surgical-orthodontic treatment of a 20 year old male patient with class III dentofacial deformity. <span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-variant: normal;"><strong>Case managements: </strong><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">To allow adequate surgical movement, both maxillary first premolars were extracted, and the maxillary incisors were retracted. No <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">extractions were performed in the mandibular arch. Surgery included a Le Fort I osteotomy with 8 mm advancement, a bilateral sagittal <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">split osteotomy with the mandibula was set back 13 mm at right side and 11 mm at left side for the correction of dental midline and <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">chin deviation. The genioplasty treatment also was done. <span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-variant: normal;"><strong>Conclusion: </strong><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">Surgical-orthodontic treatment could be chosen as a treatment <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">option for achieving an acceptable occlusion and a good esthetic result in a patient with a Class III dentofacial deformity. Nevertheless, <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">it should be performed by a multidisciplinary team to ensure a satisfactory outcome</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span>.</em></p><p><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em><strong>Latar belakang: </strong></em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Pasien dewasa dengan deformitas dentofacial biasanya ditangani dengan perawatan bedah orthodonti. Walaupun </em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>kasus deformitas dentofacial klas II lebih sering dijumpai, namun kebutuhan perawatan dan keinginan untuk memperbaiki profil muka </em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>lebih tinggi pada pasien dengan kasus klas III. Untuk koreksi kelainan skeletal secara menyeluruh pada maloklusi skeletal klas III maka </em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>dibutuhkan perawatan bedah ortodonti. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em><strong>Tujuan: </strong></em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Laporan kasus ini bertujuan melaporkan penanganan kasus dengan kelainan klas III </em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>maloklusion skeletal serta memperlihatkan hasil perawatan bedah ortognati yang memperbaiki profil pasien. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em><strong>Kasus: </strong></em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Perawatan bedah </em><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><em>ortodonti dilakukan pada pasien laki-laki (20 tahun) dengan kelainan deformitas dentofacial klas III. <span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-variant: normal;"><strong>Tatalaksana Kasus: </strong><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">Dilakukan <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">pencabutan premolar pertama rahang atas kanan dan kiri, kemudian dilakukan retraksi gigi insisif rahang atas, agar didapatkan <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">pergerakan yang adekuat. Tidak dilakukan pencabutan gigi pada rahang bawah. Perawatan bedah yang dilakukan adalah Le Fort I <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">osteotomy dengan memajukan rahang atas sebanyak 8mm, mandibula dimundurkan dengan tehnik bilateral sagittal split ostetomy <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">sebanyak 13 mm disebelah kanan, dan 11 mm disebelah kiri untuk koreksi dental midline dan deviasi dagu. Pasien juga mendapatkan <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">perawatan genioplasty. <span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-variant: normal;"><strong>Simpulan: </strong><span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">Bedah ortognatik dapat dipilih sebagai perawatan untuk mendapatkan oklusi dan hasil estetik yang <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">baik pada pasien dengan deformitas dentofasial kelas III. Namun demikian, perawatan perlu dilakukan oleh tim dari multidisiplin untuk <span style="font-family: Tribune-Regular; font-size: 10pt; color: #231f20; font-variant: normal;">mendapatkan hasil yang memuaskan<span style="font-family: Tribune-Regular; font-size: 9pt; color: #231f20; font-variant: normal;">.</span></span></span></span></span></span></span></span></span></span></span></span></em><br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" /></span></span></span></span></span></span></span></span></span></span></span></p>

Item Description

1978-3728
2442-9740
10.20473/j.djmkg.v46.i4.p229-234