Case Report on Surgery-First Approach.

Area of Science:

• Orthodontics
• Oral and Maxillofacial Surgery

Background:

• The surgery-first approach is increasingly utilized in orthognathic surgery for its potential to expedite treatment and improve aesthetics.
• This approach aims to achieve immediate skeletal stability and enhance facial harmony early in the treatment process.

Observation:

• A 21-year-old male presented with a skeletal Class III malocclusion, characterized by a 4 mm reverse overjet, 6 mm overbite, concave profile, and a protrusive chin, primarily concerned with facial aesthetics.
• The patient's chief complaints were related to the appearance of his lower front teeth and jaw size.

Findings:

• The patient underwent bilateral sagittal split setback osteotomy of the mandible using a surgery-first approach with nonextraction therapy.
• After 15 months of active treatment, significant improvements in facial profile and proportions were observed, with a notable reduction in mandibular prognathism.
• The treatment outcomes remained stable at a 1-year follow-up.

Implications:

• This case demonstrates the efficacy of the surgery-first approach in managing skeletal Class III malocclusion, offering a shorter treatment duration and enhanced aesthetic results.
• The successful outcome highlights the potential of leveraging natural dental decompensation within this surgical strategy for efficient treatment.
• This approach provides a valuable alternative for patients seeking prompt aesthetic correction and functional improvement in orthognathic cases.