Virtual surgical planning: Balancing esthetics, practicality, and anticipated stability in a complex Class III patient.

The treatment of skeletal Class III malocclusion with anterior open bite is a complex and challenging aspect of orthodontics. Facial esthetic factors, practicality and the anticipated stability of a provisional surgical plan must all be factored into the final decision of the actual orthodontic-orthognathic treatment. This case report presents the multidisciplinary treatment of a 39-year-old female patient with skeletal Class III, severe open bite with first dental contact being on the second molars, lateral crossbite, and crowding in both arches. The nonextraction treatment started with aligning and leveling of the teeth in both arches followed by an initial surgical plan based on the clinical evaluation of the smile esthetics. Precise surgical planning information was imported into the Virtual Surgica (VSP Orthognathics) workflow to visualize the direction and amount of movement necessary. The final plan was adjusted because of anticipated practical limitations of the surgery as well as to insure the stability. LeFort I, bilateral sagittal split osteotomies, and setback genioplasty were thus performed. After the surgery, the treatment concluded with the fine adjustment of the occlusion. In the end, good esthetic and functional outcomes with long-term stability were achieved as a result of this delicate multidisciplinary approach.

Comprehensive treatment approach for bilateral idiopathic condylar resorption and anterior open bite with customized lingual braces and total joint prostheses.

This case report describes the successful treatment of a 14-year-old girl with severe bilateral idiopathic condylar resorption and resultant mandibular retrusion, increased overjet, and anterior open bite. The nonextraction treatment plan included (1) aligning and leveling the teeth in both arches, (2) performing Le Fort I maxillary osteotomy, bilateral condylectomy, and mandibular joint replacement, and (3) postsurgical correction of the malocclusion. The orthodontic treatment was initiated with the use of custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Patient-fitted and customized temporomandibular joint implants were designed and manufactured based on the patient's stereolithic bone anatomic model. Treatment was concluded with detailed orthodontic finishing. Optimum esthetic and functional results were achieved with the cooperation of 2 specialties and the use of state-of-the-art technology.

Examination of Bolton Index comparing the traditional method with a 2-dimensional digital measurement method.

UNLABELLED: Index is one of the most important analyses in orthodontic treatment planning. It shows if there is a correct proportion in size between the maxillary and mandibular teeth. In this study we compared the digital and traditional method. METHODS: 35 dental casts were measured using a Vernier caliper. The mean value was compared with the measurements from the scanned images of the dental casts. RESULTS: The results showed that the digital method provided similar results with those of the traditional one with a mean difference of 0.23 mm. The Pearson correlation coefficients were very high and similar to each other: R = 0.989 and R = 0.988 for the Anterior Bolton Index (ABI) and Overall Bolton Index (OBI), respectively. No statistically significant differences were present from either the ANOVA or the paired t-tests. CONCLUSION: The used digital method is as accurate as the traditional one, it is faster and easier to carry out and it offers all the advantages of image storage and data for subsequent use.