Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: 04 Apr 2025

Combined Orthodontic, Orthognathic Surgical, and Prosthodontic Treatment for Severe Class III Malocclusion Using Digital Workflows

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Page Range: 123 – 131
DOI: 10.2341/23-099-S
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SUMMARY

The patient underwent combined orthodonticorthognathic surgical treatment due to her skeletal Class III malocclusion. In the first phase, orthodontic decompensation was performed with maxillary and mandibular fixed appliances. The maxillary first premolars were extracted; the created space was closed by anterior retraction. The posterior anchorage was reinforced with interradicular temporary anchorage devices. In the second phase, a digital surgical treatment plan was made with intra- and extraoral simulation (including occlusion and profile). During the orthognathic surgery, a bilateral sagittal split osteotomy with mandibular setback was combined with maxillary movements, using 3D-printed surgical splints. In the third phase, the orthodontic treatment continued to finish and settle the occlusion. Spaces were created between the upper incisors for ceramic veneers to gain proper overjet and occlusion. The last phase was prosthetic and esthetic rehabilitation. During the planning, a 2Dand 3D-smile design was created and presented to the patient as a mock-up. After digital impression and design, four E-max veneers were milled and cemented using dual cement to finish the workflow. Retention splints were created to preserve the new status as a final step.

Copyright: 2025
Figure 1.
Figure 1.

Pretreatment records.

Figure 2.
Figure 2.

Cephalometric analysis (OnyxCeph).

Figure 3.
Figure 3.

Space closure with power hooks.

Figure 4.
Figure 4.

Pre-surgical records.

Figure 5.
Figure 5.

Centric relation and mandibular occlusal splint in place.

Figure 6.
Figure 6.

Digital surgical planning with hard and soft tissue simulation.

Figure 7.
Figure 7.

Post-surgical photos with surgical splint.

Figure 8.
Figure 8.

Final result of post-surgical orthodontic phase.

Figure 9.
Figure 9.

2D and 3D digital smile designs.

Figure 10.
Figure 10.

Diagnostic mock-up and orientation grooves.

Figure 11.
Figure 11.

Prepared upper incisors.

Figure 12.
Figure 12.

Veneers after fabrication.

Figure 13.
Figure 13.

Final result.

Figure 14.
Figure 14.

Superimposed cephalograms (pretreatment cephalogram – BLACK, posttreatment cephalogram – RED).

Figure 15.
Figure 15.

Six-month follow-up intraoral picture with lower retention splint.

Contributor Notes

*Corresponding author: H-1088 Budapest, Szentkirályi utca 47, Hungary e-mail: gaeczi.zoltan@semmelweis.hu
Accepted: 05 Nov 2024
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