Efficacy of Surgery-First Approach in the Management of Severe Skeletal Class III Malocclusion: A Case Report

The surgery-first approach (SFA) is gaining popularity in orthognathic surgery because it makes treatment duration shorter and more satisfying for patients. However, its effectiveness in complex cases isn't fully understood. Here, we describe a rare case where SFA was used to fix problems caused by missing posterior teeth and a deep bite, which made traditional pre-surgery orthodontic treatment impractical. A 34-year-old woman had facial asymmetry, bite issues, and trouble chewing due to a misaligned jaw. X-rays showed the problem, confirming that orthognathic surgery was needed. Planning for the surgery involved moving the upper jaw forward and the lower jaw backward, using specific bone-cutting techniques. The surgery, done with the patient under general anesthesia, went well. Orthodontic brackets were added during surgery which was aided by an orthodontist to make follow-up orthodontic treatment easier. The patient recovered uneventfully and saw improvements in how her face looked, how her teeth fit together, and how well she could chew. Later, more orthodontic work fine-tuned her bite, making sure the changes lasted and kept her satisfied. This case shows how combining orthodontics with the surgery-first method can be successful in orthognathic surgery. It brings benefits like shorter treatment times and immediate improvements in appearance. Our results match other recent studies that also found good outcomes with the surgery-first approach and quicker recovery times. While more research is needed, our case adds to the evidence that SFA can lead to successful orthognathic surgery results.