Mandibular prognathism in a patient with an open bite: A case presentation
Keywords:
Mandibular prognathism; Open bite; Orthognathic surgery; Orthodontics; Skeletal Class IIIAbstract
Introduction: dentomaxillofacial deformities, such as the combination of mandibular prognathism and anterior open bite, present a complex clinical challenge due to their multifaceted impact on stomatognathic function, facial aesthetics, and the patient's psychosocial well-being. Successful treatment at the end of growth requires accurate diagnosis and a coordinated approach between orthodontics and maxillofacial surgery to achieve stable and satisfactory results.
Objective: to describe the diagnostic-therapeutic approach and the results obtained after combined orthodontic-surgical treatment in a patient with severe mandibular prognathism and anterior open bite.
Case presentation: an 18-year-old male patient with a family history of prognathism presented with aesthetic and functional concerns. Clinical examination revealed increased lower facial third, lip incompetence, right mandibular deviation, bilateral Class III molar relationship, a -6 mm overjet, and a 2.7 mm anterior open bite. Cephalometric analysis confirmed the diagnosis of severe skeletal discrepancy (anb = -6°). Treatment consisted of a pre-surgical orthodontic decompensation phase, followed by bimaxillary surgery and a final orthodontic phase of occlusal detailing.
Conclusions: integrated orthodontic-surgical management effectively corrected this complex skeletal deformity. A stable Class I occlusion was achieved, the open bite was eliminated, and facial harmony was significantly improved. This case highlights the crucial importance of multidisciplinary teamwork and sequential planning to simultaneously address function and esthetics, positively impacting the patient's quality of life.
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