Dr. Sergei Gerasimov
Education – 1st State Medical University, Saint-Petersburg, Russia
Private orthodontic practice since 1992
Lingual orthodontics since 1997
Lingual orthodontics activity: Active member since 2002
5 ESLO 2002, Berlin – poster presentation
7 ESLO 2006, Venice – oral presentation
8 ELSO 2008, Cannes – oral presentation
2 WLSO 2007, Seoul – oral presentation
5 WSLO 2013, Paris – oral presentation
11 ELSO 2014, Lake Como/Cernobbio – oral presentation
6 WSLO 2015, Seoul – oral presentation
Title: Orthognatic surgery in combined lingual orthodontic treatment. Long term stability.
AIMS: The vast majority of severe Class III malocclusions cannot be effectively treated without orthognatic surgery aid. There are many different surgical protocols depending on their influence on final patient's appearance: mandibular retraction, maxillary advancement, bimaxillary surgery, various types of rotation. In our presentation we would like to discuss various methods of treatment from long term stability point of view.
METHODS: As a rule, Class III malocclusions are formed by lower jaw enlargement. Therefore, pathogenetic surgical treatment would involve mandibular retraction. However, lower jaw resizing often collides with muscular habits, which sometimes leads to relapse. On the contrary, maxillary advancement increases the room for tongue and does not displace habitual muscles attachments. The main medical obstacle of the solitary upper jaw advancement is mandibular asymmetry presence. In such cases we are supposed to perform lower jaw surgery regardless of the upper one. Orthodontic decompensation prior to surgery can be accomplished by non-extraction way or two upper bicuspids extraction when arch length discrepancy is available.
Results and Conclusions: No doubt, bimaxillary surgery provides the best results of combined orthodontic treatment. Solitary maxillary advancement does not always create an ideal soft tissue profile. But it is a valid method of full Class III malocclusions correction from orthodontic point of view - comparative simplicity of post-surgical phase of treatment and good long term stability.
Authors: Dr. Sergey Gerasimov, private practice, Saint-Petersburg, Russia Dr. Marina Parshina, private practice, Saint-Petersburg, Russia