Surgical Corticotomy-Assisted Orthodontics in the Management of Bimaxillary Prognathism

The aim of this case report is to present the effectiveness of corticotomy-assisted orthodontic camouflage treatment in an adult patient who refused orthognathic surgery, focusing on the management of mandibular protrusion and the clinical outcomes achieved.

A 24-year-old male with skeletal Class III malocclusion, mandibular protrusion, anterior crossbite, and diastemas refused orthognathic surgery. A localized corticotomy with bone grafting was performed in the mandibular anterior region before active treatment. Fixed appliances with a 0.022″ MBT system were bonded, and sequential NiTi and stainless steel archwires were used. Temporary anchorage devices (TADs) and elastomeric chains facilitated controlled anterior retraction, while an occlusal composite ramp prevented traumatic contacts.

Corticotomy-induced regional acceleratory phenomenon (RAP) facilitated efficient anterior retraction, minimized risks of dehiscence and root resorption, and shortened treatment duration. Post treatment records demonstrated improved sagittal and vertical relationships, closure of diastemas, correction of crossbite, and significant enhancement of facial esthetics. A fixed lingual retainer was bonded in the mandibular arch to maintain stability during the retention phase.

Corticotomy-assisted orthodontics provided a safe and efficient alternative to surgery for mandibular protrusion, enabling effective anterior retraction and favorable esthetic outcomes in a shorter treatment period.