title: Surgical and orthodontic treatment of skeletal Class III featuring severe transversal and sagittal discrepancy.
abstract: OBJECTIVE
  Anterior cross-bite is a difficult malocclusion to treat in adult patients, especially if compounded by skeletal discrepancy. The present study describes a dentoskeletal Class III case and aims to provide the clinician with rational guidelines for presurgical orthodontic preparation and postsurgical finishing.
  
  
  METHODS
  In this case, a 20-year-old male patient, R.M, was treated for severe dental and skeletal Class III malocclusion on both the transversal and anteroposterior planes via combined orthodontics and surgery. Initially, the treatment involved surgically-assisted expansion of the upper jaw (total 1 month), followed by a fixed-orthodontics phase to decompensate for the malocclusion in preparation for movement of the osseous bases with the aim of achieving maximum coordination of the dental arches. After 19 months of orthodontic preparation, the patient underwent combined orthognathic surgery (upper and lower jaws). In the subsequent 4 months, orthodontic stabilization and finishing were performed, and debonding was carried out 24 months after the start of active treatment.
  
  
  RESULTS
  The combined orthodontic and surgical treatment adequately corrected the severe Class III over a period of 2 years, leading to a satisfactory occlusal, functional and aesthetic result.
  
  
  CONCLUSIONS
  Thorough diagnosis and close communication between the orthodontist and maxillofacial surgeon, operating as an interdisciplinary team, ensures good outcomes, even in complex orthodontic and surgical cases.
authors.affiliation: Department of Orthodontics University of Ferrara, Via Savonarola 9, 44121 Ferrara, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Derton
authors.forename: Antonio
authors.initials: A
authors.lastname: Gracco
authors.forename: Olindo
authors.initials: O
authors.lastname: Procopio
mesh_terms: D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008313:Malocclusion, Angle Class III / Q000150:complications / Q000601:surgery / Q000628:therapy*; D008334:Mandible / Q000002:abnormalities; D003765:Models, Dental; D017090:Occlusal Splints; D009971:Orthodontics, Corrective / Q000295:instrumentation / Q000379:methods*; D056948:Orthognathic Surgical Procedures; D010155:Palatal Expansion Technique; D010348:Patient Care Team; D011378:Prognathism / Q000601:surgery; D011862:Radiography, Panoramic; D055815:Young Adult