title: Multimodality treatment for rehabilitation of adult orthodontic patient with complicated dental condition and jaw relation.
abstract: A 50-year-old man with severe malocclusion requested comprehensive oral rehabilitation. He presented with retrognathic mandible, anterior deep bite and a gummy smile in the premaxilla, and tenting occlusal plane with severe buccal crossbite of the left maxillary posterior teeth. Inappropriate fixed prostheses spanned the maxilla and the mandible with a class II jaw relationship. A detailed analysis indicated the need for orthodontic treatment, orthognathic surgery, bone graft at the deficient alveolar ridge for implant surgery and a revision of all prostheses. Over a 2-year-period of management, the patient received anterior osteotomy for intrusion of lower anterior teeth, bilateral sagittal splitting osteotomy for mandible advancement and posterior osteotomy for inward upward repositioning of posterior teeth of the left maxilla to correct major jaw deformities. The deficient alveolar ridge in the premaxilla was augmented by autogenous bone graft harvested during the orthognathic surgery. He sequentially had mini-plate and dental implant as anchorage assisting teeth alignment in the mandible. Two 3-fixture-supported implant prostheses were delivered in the premaxilla and the mandible. The improvement in cosmesis, stability and function through treatment and a 2-year clinical follow-up were considered satisfactory.
authors.affiliation: Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Liaw
authors.forename: Shou-Hsin
authors.initials: SH
authors.lastname: Kuang
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Kai-Feng
authors.initials: KF
authors.lastname: Hung
authors.forename: Hsiu-Chin
authors.initials: HC
authors.lastname: Tsai
authors.forename: Shou-Yen
authors.initials: SY
authors.lastname: Kao
authors.forename: Jenny Hwai-Jen
authors.initials: JH
authors.lastname: Fong
mesh_terms: D006801:Humans; D007574:Jaw Relation Record; D008297:Male; D008310:Malocclusion / Q000601:surgery*; D008875:Middle Aged; D063173:Retrognathia / Q000601:surgery*