上下顎同時移動術により下顔面高の過大を改善した骨格性下顎前突症例

The patient was a 18-year 6-month female, and her chief complaint was mandibular protrusion with occlusal disturbance. Her facial profile was concave with a naso-maxillary hypoplasia and long anterior facial height, and the ratio of the upper, middle and lower facial height was 1:1.1:1.3. The upper right first molar and both the upper second premolars were missing and total crossbite was present. For the correction of skeletal mandibular protrusion with total crossbite, two-jaw surgery was required. After starting distal movement of the upper right second molar, multi-bracket appliances were placed on the upper and lower dentitions. After 1-year and 3-month of pre-operative orthodontic treatment, she received a surgery of LeFort I midfacial advancement for the maxillary and the bilateral intaoral vertical ramus osteotomy was also performed for the mandible. After 1-year and 6-month of post-operative treatment, an acceptable and stable occlusion was achieved and the multibracket appliances were removed. Overall facial balance was improved, and the ratio of facial height was changed into 1:1:1.1. At 3-year and 10-month after surgery, the acceptable occlusion was maintained.