Class III occlusion with missing maxillary first molars and facial asymmetry treated with intraoral vertical ramus osteotomy: 7-year follow-up.

A 17-year-old girl with a Class III occlusion and facial asymmetry was treated with orthodontics and intraoral vertical ramus osteotomy (IVRO). She had a severe skeletal Class III relationship (Wits, -17 mm). Even though she had a prognathic mandible, she showed a straight rather than concave profile because of severe mandibular dental compensation. The patient also had severe mandibular deviation. After 17 months of presurgical orthodontic treatment, IVRO was performed. Total active treatment time was 26 months. Both occlusion and facial appearance were significantly improved by the surgical-orthodontic treatment. There were no functional problems during or after treatment. Posttreatment records after 7 years showed excellent results with good, stable occlusion; facial balance and harmony; and long-term stability.