Orthodontic-Surgical Management of Skeletal Class III Malocclusion: A Case-Based Approach

Abstract

Skeletal Class III malocclusions in adults pose significant treatment challenges due to the involvement of complex skeletal discrepancies such as maxillary deficiency, mandibular prognathism, or a combination of both. This case report highlights two adult patients with distinct skeletal Class III presentations, one with mandibular prognathism and chin deviation, and the other with midfacial retrusion accompanied by an anterior open bite. Both patients underwent comprehensive treatment involving presurgical orthodontic decompensation using MBT appliances, followed by orthognathic surgery. Surgical interventions included Le Fort I osteotomy for maxillary advancement and bilateral sagittal split osteotomy (BSSO) for mandibular setback. Post-treatment outcomes revealed marked improvements in occlusion, facial aesthetics, and overall patient satisfaction. These cases emphasize the importance of a coordinated orthodontic-surgical approach for achieving functional stability and aesthetic harmony in adult patients with severe skeletal Class III malocclusions.