CASE REPORT 5

A PATIENT NAMED KOMAL , 21 YEARS FEMALE REPORTED TO THE OUTPATIENT DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY OF FACULTY OF DENTAL SCIENCES, SGT UNIVERSITY GURGAON WITH A CHIEF COMPLAINT OF EXCESSIVELY PROMINENT CHIN AND PROTRUDED LOWER LIP SINCE LAST 6 YEARS. EXTRAORAL EXAMINATION REVEALED MESOCEPHALIC HEAD AND MESOPROSOPIC FACIAL FORM WITH A CONCAVE FACIAL PROFILE. THE PATIENT PRESENTED WITH A GROSS FACIAL ASYMMETRY WITH SUNKEN CHEEKS, REDUCED MALAR PROMINENCE, A DEEP MENTOLABIAL SULCUS AND AN ANTERIORLY DIVERGENT FACE. LIPS WERE COMPETENT. ON INTRAORAL EXAMINATION, A CLASS III MOLAR RELATION WAS SEEN WITH AN INTERINCISAL OPENING OF 42 MM AND MIDLINE SHIFTED TO THE LEFT SIDE. A HYPOPLASTIC UPPER LIP WITH DEVIATION OF JAW TO LEFT SIDE WHILE CLOSURE OF THE MOUTH WAS SEEN.

CEPHALOMETRIC ANALYSIS WAS DONE FOR THE PATIENT WHICH CONFIRMED THE CLINICAL FINDINGS. THE TREATMENT WAS PLANNED UNDER THREE DISTINCT PHASES.

1. PRESURGICAL ORTHODONTICS
2. ORTHOGNATHIC SURGERY
3. POSTSURGICAL ORTHODONTICS

TREATMENT:

MAXILLARY ADVANCEMENT WITH DOWNGRAFTING ALONG WITH BILATERAL SAGGITAL SPLIT OSTEOTOMY WAS DONE UNDER GENERAL ANESTHESIA. MAXILLARY ADVANCEMENT WAS DONE BY 6 MM ALONG WITH 6 MM OF MANDIBULAR SETBACK WAS DONE. BOTH MAXILLA AND MANDIBLE WERE FIXED INTO THE DESIRED POSTION USING 2 MM CHAMPY’S MINIPLATE. PRIMARY CLOSURE WAS DONE USING 3-0 VICRYL SUTURES.

POSTOPERATIVE STATUS:

POSTOPERATIVELY THE PATIENT IS SATISFIED WITH HER ESTHETIC FACIAL APPEARANCE AND IS CURRENTLY UNDERGOING POSTSURGICAL ORTHODONTIC CORRECTION.