Prosthognathic rehabilitation of a patient with underlying skeletal discrepancy- a case report.
Vertical and anterioposterior maxillary excesses can be treated with a combination of orthopaedic functional appliances, orthodontics and surgery. Treatment varies according to the age, patient reports for treatment. In patients who are treated with either of the above mentioned treatment modalities, if they require prosthetic replacement on a later date, especially of anterior teeth, prosthetic treatment alone does not give an aesthetic outcome. A partially edentulous, elderly patient with underlying skeletal discrepancy (Class II Skeletal deformity) in relation to 12,11,21,22 was treated with a combination of orthognathic surgery and prosthetic rehabilltation. An orthognathic surgery (leforte I osteotomy) was performed to manage vertical maxillary excess, class II skeletal pattern of maxilla and increased lower third facial height. Dental compensations in the mandibular arch were decompensated surgically with lower subapical osteotomy. Prosthetic restorations of missing anterior teeth were done later, such that facial and dental aesthetics. The records showed that the results were stable 12 months after prosthognathic (prosthodontic and orthognathic) treatment. A team approach enabled the female patient in her fifth decade of life, to receive better function, aesthetics and increased quality of life. Doing prosthetic restorations in patients with underlying skeletal discrepancies may become a challenge , which should be achieved without compromising on final outcome, with a calculated risk benefit ratio.
Senior Lecturer, Department of Prosthodontics, Tagore Dental College and Hospital , Chennai, India .
Ashish R
AR
Jain
Senior Lecturer, Department of Oral and Maxillofacial Surgery, Ragas Dental College and Hospital , Chennai, India .
James Antony Bhagat
JA
M
Reader, Department of Prosthodontics, Saveetha University , Chennai, India .
Deepak
D
Nallaswamy
Professor and HOD, Department of Oral and Maxillofacial Surgery, Saveetha University , Chennai, India .
Vinod
V
Narayanan
Professor and HOD, Department of Prosthodontics, Saveetha University , Chennai, India .
Padma
P
Ariga
Fixed prosthesis; Orthognathic surgery; Prosthognathic