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Surgical Management of Skeletal Class II Deformity Patients- a Case Series

Received: 20 October 2020     Accepted: 6 November 2020     Published: 8 December 2020
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Abstract

Class II malocclusions constitute a high percentage of ortho-surgically treated cases. Approximately 70% of the patients have associated skeletal discrepancy characterized by an exaggerated sagittal distance between the maxilla and the mandible, which could result in maxillary prognathism, mandibular retrognathism, or both (2) Class II malocclusion can be treated by a combination of maxillary and mandibular surgeries, maxillary surgery alone or by mandible surgery solely depending on the underlying skeletal discrepancy i.e Maxillary Le Fort I superior repositioning with autorotation of mandible, Bi-jaw surgery—bilateral sagittal split osteotomy (BSSO) along with maxillary Le Fort I impaction., Genioplasty-advancement of chin. Material and methods: 10 cases of Skeletal Class –II malocclusion were selected randomly irrespective of age, sex, caste, religion, etiology and socioeconomic status, good general health without any systemic disease. Study was conducted in the Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Uvarsad. Conclusion: 14 According to the outcomes of the cases it provided a reliable esthetic and functional enhancement of the patient when maxilla was superiorly positioned, with mandibular advancement, genioplasty for retruded chin according to the treatment planned for each patient.

Published in International Journal of Clinical Oral and Maxillofacial Surgery (Volume 6, Issue 2)
DOI 10.11648/j.ijcoms.20200602.16
Page(s) 49-55
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Skeletal Class II, Deformity, Orthognathic Surgery, Surgical Management

References
[1] Sundararajan S, Parameswaran R, Vijayalakshmi D. Orthognathic surgical approach for management of skeletal class II vertical malocclusion. Contemp Clin Dent. 2018 Jun 1; 9 (5).
[2] Donjuán Villanueva JJ, Vásquez Estrada HA, Hernández Carvallo JR, Nachón García MG. Surgical-orthodontic treatment in a class II malocclusion patient. Case report. Rev Mex Ortod. 2016.
[3] Gupta H, Autar R, Abraham J, Bagchi P, Gupta S. Combined orthodontic and surgical correction of adult skeletal class II with hyperdivergent jaws. Natl J Maxillofac Surg. 2012; 3 (1): 6.
[4] Sarnat BG. Effects and noneffects of personal environmental experimentation on postnatal craniofacial growth. J Craniofac Surg. 2001; 12 (3): 205–1.
[5] Janson M, Janson G, Sant’Ana E, Simão TM, De Freitas MR. An orthodontic-surgical approach to class II subdivision malocclusion treatment. J Appl Oral Sci. 2009; 17 (3): 266–7.
[6] Forssell K, Turvey TA, Phillips C, Proffit WR. Superior repositioning of the maxilla combined with mandibular advancement: Mandibular RIF improves stability. Am J Orthod Dentofac Orthop. 1992; 102 (4): 342–5.
[7] Matsushita K, Yamaguchi HO, Koshikawa-Matsuno M, Inoue N. Evaluation of a three-stage method for improving mandibular retrognathia with labially inclined incisors using genioplasty, segmental osteotomy, and two-jaw surgery. Case Rep Med. 2014; 201.
[8] Krishna Nayak US. Surgical Orthodontic treatment of Skeletal Class II malocclusion. Vol. 3, Journal of Scientific Dentistry.
[9] Katta A, Rajasigamani K, Balachander R, Karthik K. Surgical correction of class II skeletal malocclusion in an adult patient. J Orofac Sci [Internet]. 2014 [cited 2019 Dec 5]; 6 (1): 5 Available from: http://www.jofs.in/text.asp?2014/6/1/58/132587.
[10] Chhibber A, Upadhyay M, Uribe F, Nanda R. Long-term surgical versus functional Class II correction: A comparison of identical twins. Angle Orthod. 2015 Jan 1; 85 (1): 142–5.
[11] Daokar ST, Agrawal G, Chaudhari C, Yamyar S. Ortho-surgical Management of Severe Skeletal Class II Div 2 Malocclusion in Adult. Orthod J Nepal. 2018 Jan 7; 7 (1): 44–5.
[12] Wertz RA. Diagnosis and treatment planning of unilateral class II malocclusions. Angle Orthod. 1975; 45 (2): 85–9.
[13] Schendel SA, Eisenfeld JH, Bell WH, Epker BN. Superior repositioning of the maxilla: Stability and soft tissue osseous relations. Am J Orthod. 1976; 70 (6): 663–7.
[14] Epker BN, Fish LC. Surgical superior repositioning of the maxilla: What to do with the mandible? Am J Orthod. 1980; 78 (2): 164–9.
Cite This Article
  • APA Style

    Mehta Payal, Nimisha Desai, Nehal Patel, Tushar Makwana. (2020). Surgical Management of Skeletal Class II Deformity Patients- a Case Series. International Journal of Clinical Oral and Maxillofacial Surgery, 6(2), 49-55. https://doi.org/10.11648/j.ijcoms.20200602.16

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    ACS Style

    Mehta Payal; Nimisha Desai; Nehal Patel; Tushar Makwana. Surgical Management of Skeletal Class II Deformity Patients- a Case Series. Int. J. Clin. Oral Maxillofac. Surg. 2020, 6(2), 49-55. doi: 10.11648/j.ijcoms.20200602.16

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    AMA Style

    Mehta Payal, Nimisha Desai, Nehal Patel, Tushar Makwana. Surgical Management of Skeletal Class II Deformity Patients- a Case Series. Int J Clin Oral Maxillofac Surg. 2020;6(2):49-55. doi: 10.11648/j.ijcoms.20200602.16

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  • @article{10.11648/j.ijcoms.20200602.16,
      author = {Mehta Payal and Nimisha Desai and Nehal Patel and Tushar Makwana},
      title = {Surgical Management of Skeletal Class II Deformity Patients- a Case Series},
      journal = {International Journal of Clinical Oral and Maxillofacial Surgery},
      volume = {6},
      number = {2},
      pages = {49-55},
      doi = {10.11648/j.ijcoms.20200602.16},
      url = {https://doi.org/10.11648/j.ijcoms.20200602.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcoms.20200602.16},
      abstract = {Class II malocclusions constitute a high percentage of ortho-surgically treated cases. Approximately 70% of the patients have associated skeletal discrepancy characterized by an exaggerated sagittal distance between the maxilla and the mandible, which could result in maxillary prognathism, mandibular retrognathism, or both (2) Class II malocclusion can be treated by a combination of maxillary and mandibular surgeries, maxillary surgery alone or by mandible surgery solely depending on the underlying skeletal discrepancy i.e Maxillary Le Fort I superior repositioning with autorotation of mandible, Bi-jaw surgery—bilateral sagittal split osteotomy (BSSO) along with maxillary Le Fort I impaction., Genioplasty-advancement of chin. Material and methods: 10 cases of Skeletal Class –II malocclusion were selected randomly irrespective of age, sex, caste, religion, etiology and socioeconomic status, good general health without any systemic disease. Study was conducted in the Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Uvarsad. Conclusion: 14 According to the outcomes of the cases it provided a reliable esthetic and functional enhancement of the patient when maxilla was superiorly positioned, with mandibular advancement, genioplasty for retruded chin according to the treatment planned for each patient.},
     year = {2020}
    }
    

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    T1  - Surgical Management of Skeletal Class II Deformity Patients- a Case Series
    AU  - Mehta Payal
    AU  - Nimisha Desai
    AU  - Nehal Patel
    AU  - Tushar Makwana
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    DO  - 10.11648/j.ijcoms.20200602.16
    T2  - International Journal of Clinical Oral and Maxillofacial Surgery
    JF  - International Journal of Clinical Oral and Maxillofacial Surgery
    JO  - International Journal of Clinical Oral and Maxillofacial Surgery
    SP  - 49
    EP  - 55
    PB  - Science Publishing Group
    SN  - 2472-1344
    UR  - https://doi.org/10.11648/j.ijcoms.20200602.16
    AB  - Class II malocclusions constitute a high percentage of ortho-surgically treated cases. Approximately 70% of the patients have associated skeletal discrepancy characterized by an exaggerated sagittal distance between the maxilla and the mandible, which could result in maxillary prognathism, mandibular retrognathism, or both (2) Class II malocclusion can be treated by a combination of maxillary and mandibular surgeries, maxillary surgery alone or by mandible surgery solely depending on the underlying skeletal discrepancy i.e Maxillary Le Fort I superior repositioning with autorotation of mandible, Bi-jaw surgery—bilateral sagittal split osteotomy (BSSO) along with maxillary Le Fort I impaction., Genioplasty-advancement of chin. Material and methods: 10 cases of Skeletal Class –II malocclusion were selected randomly irrespective of age, sex, caste, religion, etiology and socioeconomic status, good general health without any systemic disease. Study was conducted in the Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Uvarsad. Conclusion: 14 According to the outcomes of the cases it provided a reliable esthetic and functional enhancement of the patient when maxilla was superiorly positioned, with mandibular advancement, genioplasty for retruded chin according to the treatment planned for each patient.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, India

  • Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, India

  • Fellowship in Cleft and TMJ, ABMSS Cleft Center, Surat, India

  • Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, India

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