Surgical-orthodontic with atypical extraction pattern as a treatment for an anterior open bite: A case report

This case report described th e surgical- orthodontic interdisciplinar y t reatment of a patie nt with skeletal anterior open bite, class III skelet al pa ttern, steep mandibular plane, increa sed lower face heigh t, and thin mandibular sym physis. The or thodontic p reparation included an unusual extraction pattern (maxillary right first molar, maxillary left second premolar, and mandibular right central incisor), combined with two-jaw surger y comprised of maxillar y advancement and d ifferential impac tion, b ilateral malarplasty augme ntation and man dib ula r asymmetric bilateral sagittal split osteotomy setback. The follow-up of a rare complication of surgical hooks breakage during surgery is reported. Guided by 3- dimesional digital platforms, treatment planning and execution, resulted in a more ba lan ced a nd proportionate face with functional occlusion, and the case stability is shown i n a 32-m onth follow-up.