Oral Rehabilitation of Patients with Angle Class III Malocclusion and Teeth Loss through a Multidisciplinary Approach, Including Orthognathic Surgery and Implant Prosthetic Rehabilitation
Keywords :
Implant prosthetic rehabilitation, Orthognathic surgery, Skeletal class III malocclusion
Citation Information :
Gagik H, Levon K, Grigor K, Gegham T. Oral Rehabilitation of Patients with Angle Class III Malocclusion and Teeth Loss through a Multidisciplinary Approach, Including Orthognathic Surgery and Implant Prosthetic Rehabilitation. Int J Prosthodont Restor Dent 2020; 10 (1):12-20.
Aim: The aim of the study is to assess treatment success of teeth loss patients with class III skeletal malocclusion through a multidisciplinary approach, including orthognathic surgery and implant prosthetic rehabilitation. Materials and methods: The present retrospective study investigated the 5-year clinical treatments outcomes 16 patients with class III malocclusion and teeth loss. Clinical, laboratory, radiological methods were used in the examination of patients. Surgical stage included sagittal bilateral osteotomy of the lower jaw and reposition it back (Le Fort I osteotomy). 7–8 months after the orthognathic surgery 132 implants were inserted. After 2 to 4 months of submerged healing period patients had received implant-fixed prostheses. Results: No serious intraoperative or immediate postoperative complications were noted. At the control examination after 6 months after surgery, from an X-ray examination we did not observe any clinical or radiological signs of inflammation in the area of osteotomy sites and titanium mini-plates. Success rate of implants after 5 years was 96.2%. Conclusion: After orthognathic surgery and dental implant prosthetic rehabilitation, the masticatory function, esthetics of the facial profile, and occlusion were improved. Patients expressed satisfaction with the result of treatment and improved quality of life.
Fox GL, Tilson HB. Mandibular retrognathia: a review of the literature and selected cases. J Oral Surg 1976;34(1):53–61.
de Lir ALS, de Moura WL, Oliveira Ruellas AC, et al. Long-term skeletal and profile stability after surgical-orthodontic treatment of class II and class III malocclusion. J Craniomaxillofac Surg 2013;41(4):296. DOI: 10.1016/j.jcms.2012.10.001.
Sato FRL, Asprino L, Consani S, et al. A comparative evaluation of the hybrid technique for fixation of the sagittal split ramus osteotomy in mandibular advancement by mechanical, photoelastic, and finite element analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114(5 Suppl):S60–S68. DOI: 10.1016/j.tripleo.2011.08.027.
Park JU, Baik SH. Classification of angle class III malocclusion and its treatment modalities. Int J Adult Orthod Orthognath Surg 2001;16(1):19–29.
Benech A, Mazzanti C, Arcuri F, et al. Simultaneous Le Fort I osteotomy and computer-guided implant placement. J Craniofac Surg 2011;22(3):1042–1046. DOI: 10.1097/SCS.0b013e318210765d.
Sakar O, Beyli M, Marsan G. Combined prosth-odontic and orthodontic treatment of a patient with a class III skeletal malocclusion: a clinical report. J Prosthet Dent 2004;92(3):224–228. DOI: 10.1016/j.prosdent.2004.06.002.
Moraschini V, Poubel LA, Ferreira VF, et al. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg 2015;44(3):377–388. DOI: 10.1016/j.ijom.2014. 10.023.
Honda K, Hirota M, Iwai T, et al. Orthognathic surgery and implant-supported bridge in a class III patient injured in a motor vehicle accident. J Craniofacial Surgery 2018;29(3):296–298. DOI: 10.1097/SCS.0000000000004339.
Bakke M, Holm B, Jensen BL, et al. Unilateral, isometric bite force in eight 68-year old woman and men related to occlusal factors. Scand J Dent Res 1990;98(2):149–158. DOI: 10.1111/j.1600-0722.1990.tb00954.x.
Rendell J, Grasso JE, Gay T. Retention and stability of the maxillary denture function. J Prosthet Dent 1995;73(4):344–347. DOI: 10.1016/s0022-3913(05)80329-4 Foltán R, Hoffmannová J, Pavlíková G. The influence of orthognathic surgery on ventilation during sleep. Int J Oral Maxillofac Surgery 2011;40:146–149.
Kämmerer PW, Wolf JM, Dau M, et al. Orthognathic surgery for correction of skeletal class III malocclusion using osseointegrated dental implants: a clinical case letter. J Oral Implantol 2020;46(2): 146–152. DOI: 10.1563/aaid-joi-D-19-00113.
Westermark A, Bystedt H, von Konow L. Inferior alveolar nerve function after sagittal split osteotomy of the mandible: correlation with degree of intraoperative nerve encounter and other variables in 496 operations. British Journal of Oral and Maxillofacial Surgery 1998;36(6):429–433. DOI: 10.1016/S0266-4356(98)90458-2.
Acebal-Bianco F, Vuylsteke PL, Mommaerts MY, et al. Perioperative complications in corrective facial orthopedic surgery: a 5-year retrospective study. J Oral Maxillofac Surg 2000;58(7):754–760. DOI: 10.1053/joms.2000.7874.
Buttke TM, Profitt WR. Referring adult patients for orthodontic treatment. J Am DentAssoc 1999;130(1):73–79. DOI: 10.14219/jada.archive.1999.0031.
Williams AC, Shah H, Sandy JR, et al. Patients’ motivations for treatment and their experiences of orthodontic preparation for orthognathic surgery. J Orthod 2005;32(3):191–202. DOI: 10.1179/146531205225021096.
Pinho T, Neves M, Alves C. Multidisciplinary management including periodontics, orthodontics, implants, and prosthetics for an adult. Am J Orthod Dentofacial Orthop 2012;142(2):235–245. DOI: 10.1016/j.ajodo.2010.10.026.
Uribe F, Janakiraman N, Nanda R. Interdisciplinary approach for increasing the vertical dimension of occlusion in an adult patient with several missing teeth. Am J Orthod Dentofacial Orthop 2013;143(6):867–876. DOI: 10.1016/j.ajodo.2012.05.022.
Misch CE, Perel ML, Wang HL, et al. Implant success, survival, and failure: the international congress of oral implantologists (ICOI) Pisa consensus conference. Implant Dent 2008;17(1):5–15. DOI: 10.1097/ID.0b013e3181676059.
Allen F, Locker D. A modified short version of the oral health impact profile for assessing health-related quality of life in edentulous adults. Int J Prosthodont 2002;15(5):446–450.
Galindo-Moreno P, León-Cano A, Ortega-Oller I, et al. Marginal bone loss as success criterion in implant dentistry: beyond 2 mm. Clin Oral Implants Res 2015;26(4):e28–e34. DOI: 10.1111/clr.12324.
Ellis E, Macnamara JA. Components of adult class III malocclusion. J Oral Maxillofac Surg 1984;42(5):295–305. DOI: 10.1016/0278-2391(84)90109-5.
Weissheimer A, Menezes LM, Koerich L, et al. Fast three-dimensional superimposition of cone beam computed tomography for orthopaedics and orthognathic surgery evaluation. Int J Oral Maxillofac Surg 2015;44(9):1188–1196. DOI: 10.1016/j.ijom.2015.04.001.
Devita R, Pinho S, Ustrell J, et al. Multidisciplinary oral rehabilitation in partially edentulous adult patients with malocclusion: a cross-sectional survey study. J Clin Exp Dent 2018;10(12):1177–1183. DOI: 10.4317/jced.55282.
Al-Rethia R, Al-Dayel. A. A novel approach for a prosthetically driven treatment planning of a class III skeletal malocclusion: a case report. Saudi Dent J 2019;31:9–10. DOI: 10.1016/j.sdentj.2019.01.031.
Jain S, Aggarwal S, Mahajan T, et al. A transdisciplinary approach for treatment of class III malocclusion. 2019;8(10):3412–3415. DOI: 10.4103/jfmpc.jfmpc_601_19.
Peacock ZS, Lee CCY, Klein KP, et al. Orthognathic surgery in patients over 40 years of age: indications and special considerations. 2014;72(10):1995–2004. DOI: 10.1016/j.joms.2014.03.020.
Dias L, Leandro W, Marcos R, et al. Combined orthognathic surgery and prosthetic treatment for class III skeletal malocclusion. Stomatos 2013;19(37):10–19.
Perillo L. Early treatment of dentoskeletal class III malocclusion: SEC III protocol. APOS Trends Orthod 2019;9:73–76. DOI: 10.25259/APOS-56-2019.
Eslami S, Faber J, Fateh A, et al. Treatment decision in adult patients with class III malocclusion: surgery versus orthodontics. Prog Orthod 2018;19(1):28. DOI: 10.1186/s40510-018-0218-0.
Kim J-Y, Park JH, Jung H-D, et al. Factors affecting total treatment time in patients treated with orthognathic surgery using the surgery-first approach: multivariable analysis using 3D CT and scanned dental casts. J Clin Med 2020;9(3):641. DOI: https://doi.org/10.3390/jcm9030641.