Case report CB. Surgical vs nonsurgical treatment in the nongrowing patient

With an increase in the number of adults currently seeking orthodontic care, the orthodontist will invariably be faced with the planning and execution of treatment for nongrowing patients with significant skeletal discrepancies. Surgical orthodontic treatment may be the preferred mechanical choice in many of the cases, but may not fit the patient's financial or emotional capabilities. It is often incumbent upon the orthodontist to present alternative treatment options along with the risks and benefits inherent in the dentoalveolar compensation of a malocclusion which is predominantly skeletal. Traditional concerns have been with periodontal and dentoalveolar stability, intermaxillary dental function and soft tissue facial aesthetics with more recent focus on the medical-legal implications of potentially altered temporomandibular joint function. Ultimately the decision to undertake an alternative treatment plan, postpone combination surgical/orthodontic treatment or opt for no treatment must lie with the well informed patient. The following case represents many of the considerations and comprises involved with the treatment of a nongrowing skeletal Class II problem.