Computer-Aided Surgical Planning을 이용한 안면비대칭 III급 환자의 조기 양악 수술

Abstract

Surgical-orthodontic treatment is aimed to restore occlusal function, harmonize a maxillofacial complex, and improve facial esthetics. As patients with dentofacial deformities desire an immediate improvement of appearance, surgery-first or surgery-early approach with minimal presurgical orthodontics has been reported. In addition, three-dimensional analysis using CBCT and computer-aided surgical planning (CASP) have made it possible to perform more accurate treatment plans for orthognathic surgery. This case report describes a successful surgery-early approach in a Class III patient with facial asymmetry. A 23-year-old male patient presented to our clinic with facial asymmetry and mandibular prognathism. The three-dimensional analysis showed mandibular deviation to the right side due to overgrowth of the left mandibular body, and the dentition presented canting of the occlusal plane to the left side with dental compensation of the maxillary right molars. Minimal presurgical orthodontic treatment was performed to improve arch coordination and eliminate premature contacts to achieve stable postoperative maxillo-mandibular relation. Afterward, canting correction and superior impaction of the posterior maxilla, and differential setback of the mandible were planned using CASP. Early bimaxillary surgery was performed with a 3D printed wafer. After a total of 20 months, the patient achieved a favorable facial profile and functional occlusion as planned.