2.3.5. Results and conclusions

Despite controversy, combined orthosurgical treatment of severe maxillary excess concomitant with facial skeletal disharmony remains the only treatment option. The treatment results as seen in Figures 22–24 were remarkably promising and satisfactory.

Figure 23. Phases of treatment, pretreatment, presurgical, postsurgical, and post prosthetic replacement of extraction

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Figure 24. Frontal and lateral photos of the face showing significant esthetic improvement and pleasing smile shaped by

spaces.

combined orthosurgical treatment.

#### 2.4. Case #4

A healthy patient (24 year and 10 month old) presented with a chief complaint "I am unhappy with my unaesthetic smile, lack of biting on my teeth, and prominent chin." The necessary data were collected and analyzed, and the patient was informed that orthodontic treatment


Figure 22. Pre and post treatment cephalometric analysis and panoramic views.

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Figure 23. Phases of treatment, pretreatment, presurgical, postsurgical, and post prosthetic replacement of extraction spaces.

2.3.5. Results and conclusions

138 Current Approaches in Orthodontics

2.4. Case #4

Despite controversy, combined orthosurgical treatment of severe maxillary excess concomitant with facial skeletal disharmony remains the only treatment option. The treatment results as

A healthy patient (24 year and 10 month old) presented with a chief complaint "I am unhappy with my unaesthetic smile, lack of biting on my teeth, and prominent chin." The necessary data were collected and analyzed, and the patient was informed that orthodontic treatment

seen in Figures 22–24 were remarkably promising and satisfactory.

Figure 22. Pre and post treatment cephalometric analysis and panoramic views.

Figure 21. Model surgery and diagnostic set up possible for prosthetic construction.

Figure 24. Frontal and lateral photos of the face showing significant esthetic improvement and pleasing smile shaped by combined orthosurgical treatment.

alone cannot be of benefit to you. A combined orthosurgical treatment modality was offered, and a joint meeting with the maxillofacial surgeon was arranged; details of the treatment phases, surgical risk, and cost effectiveness were explained to the patient who showed great interest in undergoing the treatment in a positive manner. The following figures reveal the steps and efforts exerted by the healthcare team and the cooperation of the patient that made the achievement possible.

plane; bilateral sagittal split osteotomy of the mandibular ramus to setback the prognathic mandible bringing narrower mandibular arch in favor of the normal transverse occlusion, anticlockwise rotation aided in correcting the open bite. Retentive means were designed to

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Mutual collaboration between healthcare providers allows for the proper selection of treatment modality relevant to the dentofacial deformity presented. Bimaxillary surgery helped in

Figure 26. Pretreatment lateral cephalometric and panoramic radiographs (essential diagnostic aids).

Figure 27. Pretreatment lateral ceph (McNamara) analysis and soft tissue surgical planning (prediction).

guarantee stable outcome (Figures 26–32).

2.4.4. Conclusions
