1.A Rehabilitation of Missing Maxillary Anterior Teeth in a Severe Skeletal Class III Malocclusion Patient Requiring Implants
Zethy Hanum Mohamed Kassim ; Abdul Latif Abdul Hamid ; Nadhirah Ghazali ; Puvanendran Balasingham
Annals of Dentistry 2021;28(1):8-14
Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a
situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed
dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in
the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to
allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion,
treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal
discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A
multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall
treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical
management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation
of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship
required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the
mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to
implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic
rehabilitation of the missing teeth using an i-FDP.