Mandibular asymmetry retreatment with minimal presurgical orthodontic preparation and fully customized lingual...

New possibilities such as Surgery-first and Minimal Presurgical Orthodontics have become extra alternatives for patients, orthodontists, and oral and maxillofacial surgeons, with immediate facial improvements, reduced preparation time, and shorter treatment time. The purpose of this case report was to demonstrate the retreatment of a female patient, dissatisfied with the instability of the compensatory orthodontic treatment, chin deviation, and forward inclination of the maxillary incisors, which was successfully treated with Minimal Presurgical Orthodontic approach associated with customized lingual brackets and virtual planning on the open-source Blender 3D software, where the post-surgical maxillary lingual brackets were also designed. Orthodontic preparation was performed in 5 months. After surgery, orthodontic treatment was finished with the aid of mini-implants and miniplates. The total treatment time was 18 months. Great facial and occlusal results were obtained and the patient was satisfied. Overall, all treatment steps were performed following a digital workflow and open-source software. It is possible to conclude that Minimal Presurgical Orthodontic Preparation was an excellent alternative for the retreatment of this patient with mandibular asymmetry and increased treatment expectations. Additionally, the surgical planning and design of lingual braces with open-source software can be considered useful and low-cost alternatives for orthodontists.