Treatment of skeletal Class Ⅲ malocclusion with mandibular lateral deviation by clear aligner therapy combined with orthognathic treatment: case report and literature review

Abstract

Objective To investigate the clinical efficacy of clear aligner therapy combined with orthognathic surgery in the treatment of skeletal Class Ⅲ mandible deviation. Methods A case of mandibular lateral deviation treated by combined orthodontic and orthognathic surgery was reported and analyzed in combination with the related literature. Clear aligner therapy was chosen for orthodontic treatment, and bilateral sagittal split ramus osteotomy and genioplasty were adopted to address the skeletal deformity. Results Eight intermaxillary fixation screws were inserted during surgery to fix the splint, and settling elastics were run to achieve better occlusion postsurgery. With good compliance of the patient, treatment was completed by the first set of aligners, Class I canine and molar relationships were obtained, normal overbite and overjet were achieved, and mandibular deviation was addressed. The stability was good 1 year after treatment. The results of the literature review showed that clear aligner therapy in conjunction with orthognathic surgery has been widely used, but there are still some challenges in front. Compared with traditional orthodontics, the digital features of clear aligner therapy makes it fit more closely with computer-aided surgery, and there is more space for exploration. Conclusion For patients with good compliance, clear aligner therapy combined with orthognathic surgery can effectively complete the treatment of simple cases. The advantage of digital design equips clear aligner therapy with good prospects for development.

Keywords

• combined orthodontic and orthognathic treatment ，
• clear aligner therapy ，
• mandibular lateral deviation ，
• open bite ，
• cross bite ，
• bilateral sagittal split ramus osteotomy ，
• genioplasty ，
• facial asymmetry ，
• intermaxillary elastics ，
• digital medicine ，
• digital splint，