A Case of Skeletal Mandibular Protrusion with Maxillary Edentulous and Mandibular Bilateral Free-end Edentulous Undergone Orthognathic Surgery

要旨

The patient was a 51-year-old female who came to the hospital because of poor retention of the upper complete denture and mandibular protrusion. The oral condition was maxillary edentulous and mandibular bilateral free-end edentulous. Based on facial findings, examination of the oral cavity, panoramic radiograph, and frontal and lateral cephalogram findings, the patient was diagnosed with skeletal mandibular prognathism. For this patient, a temporary transparent denture was made by duplicating the used complete denture. A precision impression was taken with a duplicate denture, and a new complete denture was made at a position where the mandible was moved three-dimensionally according to the amount of mandibular set-back predicted from the cephalometric trace. Later, bilateral mandibular sagittal split ramus osteotomy was performed as orthognathic surgery.The multidisciplinary approach provided the skeletal corrections of SNA, SNB and ANB as 81.8°, 81.7° and 0.1°, respectively, and also excellent facial appearance after treatment.It is suggested that preoperative cephalometric prediction, simulated by the correct postoperative mandibular position and appropriate incisal inclination, can provide valuable information for the orthognathic treatment of edentulous skeletal Class Ⅲ patients.

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