Korean J Orthod.  2014 Nov;44(6):330-341. 10.4041/kjod.2014.44.6.330.

Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction

• Im J
• Kang SH
• Lee JY
• Kim MK
• Kim JH

• KMID: 2273233
• DOI: http://doi.org/10.4041/kjod.2014.44.6.330

Abstract

A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

Keyword

Digital simulation; Digital models; Computed tomography; Surgery-first approach; Three-dimensional technique

MeSH Terms

Crowding
Dental Clinics
Dentition
Diagnosis
Female
Humans
Malocclusion
Malocclusion, Angle Class III
Maxillary Osteotomy
Molar
Osteotomy
Prognathism
Young Adult

Figure

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  Figure 1 Pretreatment extraoral and intraoral photographs.

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  Figure 2 Pretreatment panoramic radiograph and lateral and frontal cephalometric radiographs.

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  Figure 3 Pretreatment computed tomography images.

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  Figure 4 Initial dental cast model and three-dimensional digital model.

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  Figure 5 Superimposition of the initial digital cast model onto the three-dimensional computed tomography image.

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  Figure 6 Virtual setup based on prediction of the presurgical orthodontic treatment.

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  Figure 7 Three-dimensional surgical simulation using Mimics® 14.0 (Materialise, Leuven, Belgium).

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  Figure 8 Postoperative extraoral and intraoral photographs.

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  Figure 9 Postoperative panoramic radiograph and lateral and frontal cephalometric radiographs.

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  Figure 10 Intraoral photographs at one month after postsurgical orthodontic treatment.

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  Figure 11 Intraoral photographs at 3 months after postsurgical orthodontic treatment.

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  Figure 12 Intraoral photographs at 6 months after postsurgical orthodontic treatment.

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  Figure 13 Clear retainer in the maxilla and circumferential retainer in the mandible.

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  Figure 14 Posttreatment extraoral and intraoral photographs.

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  Figure 15 Posttreatment panoramic radiograph and lateral and frontal cephalometric radiographs.

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  Figure 16 Comparison of the simulated cast and computed tomography (CT) images and the posttreatment CT images using superimposition and a color-coded discrepancy map. A, Frontal view; B, oblique view; C, dental view.

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