Combined orthodontic and surgical treatment of severe mandibular laterognathie with bimaxillary protrusion: case report.

This article summarizes the treatment progress for a patient with a severe dolichofacial pattern with a convex profile, severe lip incompetency, and concomitant mouth breathing. Her maxillary occlusal plane had a cant and the maxillary and mandibular midlines were shifted 2 and 4 mm to the left side, respectively. The treatment plan summary was as follows: (1) maxillary rapid expansion for the elimination of maxillary constriction; (2) extraction of maxillary right first molar; (3) extraction of mandibular first premolars; (4) preoperative orthodontic treatment to correct dental protrusions; (5) surgical repositioning of the maxilla and mandible; and (6) postoperative orthodontic treatment and retention. Orthodontic treatment lasted a total of 28 months, with a good intercuspation and significantly improved facial esthetics at the end of treatment. The 1-year postretention lateral cephalometric measurements did not indicate any significant relapse. Dental protrusion and crowding in both jaws were eliminated. Facial and dental asymmetry was resolved and the profile was improved. The cant of the occlusal plane and the lips were corrected. Evaluation of pre- and posttreatment profiles revealed a decrease in convexity. Dentally, Class I canine and Class III molar relationships were present at the end of the treatment. Maxillary and mandibular incisors were uprighted, improving the interincisal angle and the bite relationship.