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Treatment of a severe class II subdivision malocclusion following failed bimaxillary anterior segment osteotomy: a
Viet Anh Nguyen1, Thi Minh Anh Ha2
1Faculty of Dentistry, PHENIKAA University, Yen Nghia, Ha Dong, Hanoi, 12116, Vietnam. anh.nguyenviet1@phenikaa-uni.edu.vn.
Background:
Orthognathic surgery without a well-coordinated orthodontic plan can compromise aesthetic and functional outcomes, potentially necessitating complex orthodontic retreatment.
Case Presentation:
This case report presents a 28-year-old female with residual extraction spaces and upper incisor proclination following a failed bimaxillary anterior segment osteotomy. Clinical examination revealed a convex profile, Class I skeletal base relationship, hyperdivergent facial pattern, full-cusp Class II subdivision on the left side, excessive overjet, and significant lower dental midline deviation. Treatment involved digitally planned straight-wire lingual appliances combined with miniscrew anchorage to distalize the entire upper arch and lower right quadrant, while mesializing the lower left quadrant. This approach successfully corrected the malocclusion, achieving a solid Class I relationship, normal overbite and overjet, and a harmonious profile.
Conclusions:
This case highlights the effective management of complex malocclusions arising from suboptimal orthognathic surgery through a combination of miniscrew-assisted distalization and mesialization techniques, aided by digital planning and lingual appliances.
