title: Increasing orthodontic and orthognathic surgery treatment efficiency with a modified surgery-first approach.
abstract: This case report describes the treatment of a 33-year-old white man who had a skeletal Class III and dental Class II subdivision malocclusion caused by a retrognathic maxilla, with severe maxillary crowding, a highly placed maxillary left canine, mild mandibular crowding, and a bilateral posterior crossbite. Treatment was performed with a modified surgery-first approach, which included a short presurgical alignment phase for the correction of the significant maxillary crowding while controlling the incisal angulation, followed by LeFort I maxillary advancement surgery. The short presurgical orthodontic phase aimed at eliminating the anterior dental interferences before the maxillary advancement, and the use of the inherent increased bone turnover in the postsurgical phase helped to reduce the total orthodontic treatment time to 12 months. Pleasing esthetic results and a good functional occlusion were achieved.
authors.affiliation: Charles Burstone professor and program director, Division of Orthodontics, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut, Farmington, Conn. Electronic address: Furibe@uchc.edu.
authors.forename: Flavio
authors.initials: F
authors.lastname: Uribe
authors.affiliation: Formerly, postgraduate resident, Division of Orthodontics, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut, Farmington, Conn.
authors.forename: Sachin
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Associate professor and chair, Division of Oral and Maxillofacial Surgery, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut, Farmington, Conn.
authors.forename: David
authors.initials: D
authors.lastname: Shafer
authors.affiliation: Professor and head, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut, Farmington, Conn; alumni endowed chair, School of Dental Medicine, University of Connecticut, Farmington, Conn.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Nanda
mesh_terms: D000328:Adult; D002508:Cephalometry / Q000379:methods; D004955:Esthetics, Dental; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery / Q000628:therapy; D008313:Malocclusion, Angle Class III / Q000601:surgery / Q000628:therapy; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D010347:Patient Care Planning; D011300:Preoperative Care; D063173:Retrognathia / Q000601:surgery / Q000628:therapy; D013997:Time Factors; D014087:Tooth Movement Techniques / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome