case_images: PMC11813019_01
case_images: Pretreatment facial and intraoral photographs.
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case_images: F1
case_images: A detailed diagnosis was conducted under the guidance of 6 elements (Table S1, Supplemental Digital Content, http://links.lww.com/MD/O298), focusing on the three-dimensional aspects of the soft, dental, and skeletal (Table 1, Figs. 1-4). In this patient, extraction of the mesial incisors led to a compromised aesthetic appearance of the anterior teeth and occlusal interference during mandibular movements (Fig. 15, Video S1, Supplemental Digital Content, http://links.lww.com/MD/O296).
case_images: Andrews' 6 elements analysis. (A) Element I, maxillary incisors were retracted by 2 mm, and mandibular incisors were retracted by 4 mm. (B) Element II, determine the GALL line, with the adjusted maxillary incisor FA point located 5 mm anterior to the GALL line. (C) Element IV, anterior subfacial height is slightly greater than the posterior height. (D) Element V, determine the PALL line, the pogonion is located 4 mm posterior to the PALL line.
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case_images: F2
case_images: A detailed diagnosis was conducted under the guidance of 6 elements (Table S1, Supplemental Digital Content, http://links.lww.com/MD/O298), focusing on the three-dimensional aspects of the soft, dental, and skeletal (Table 1, Figs. 1-4). Occlusal forces are adequate and evenly distributed, and there is no dental interference with any lateral and anterior movement (Fig. 22, Video S2, Supplemental Digital Content, http://links.lww.com/MD/O297).
case_images: Diagnose in 6 elements.
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case_images: F3
case_images: A detailed diagnosis was conducted under the guidance of 6 elements (Table S1, Supplemental Digital Content, http://links.lww.com/MD/O298), focusing on the three-dimensional aspects of the soft, dental, and skeletal (Table 1, Figs. 1-4).
case_images: Pretreatment radiographs. (A) Lateral cephalogram. (B) Posteroanterior cephalogram. (C) Panoramic radiograph. (D) Cephalometric analysis.
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case_images: F4
case_images: A detailed diagnosis was conducted under the guidance of 6 elements (Table S1, Supplemental Digital Content, http://links.lww.com/MD/O298), focusing on the three-dimensional aspects of the soft, dental, and skeletal (Table 1, Figs. 1-4).
case_images: Diagram of treatment plan.
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case_images: F5
case_images: Additionally, UR6 was extracted, and UR7 and UR8 were repositioned anteriorly (Fig. 5A). In the mandible, LL4 and LR4 were extracted, and the extraction gaps were used to flatten the curve, with the incisors retracted by 4 mm (Fig. 5A). A Lefort I block osteotomy was performed in the maxilla, retracting the anterior bone segment by 5 mm and adjusting the posterior bone segment to achieve coordinated width (Fig. 5B). A surgical procedure was performed in the mandible to advance the chin by 4 mm (Fig. 5B). Following orthodontic and orthognathic treatment, a maxillary anterior dental prosthesis was used to restore forward and lateral guidance (Fig. 5C).
case_images: The data of customized bracket base plate.
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case_images: F6
case_images: Bracket bonding intraoral photographs.
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case_images: F7
case_images: Presurgery facial and intraoral photographs.
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case_images: F8
case_images: At the end of the presurgical orthodontic treatment, the upper anterior teeth were exposed to 2 mm at rest (Fig. 8).
case_images: Presurgery models.
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case_images: F9
case_images: The vertical opening between the anterior teeth was 1 mm and the overjet was 8 mm in the sagittal direction (Fig. 9).
case_images: Surgical protocol design. (A) Maxillary surgery protocol, (B) upper right jaw surgery protocol, (C) upper left jaw surgery protocol.
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case_images: F10
case_images: The surgical plan included maxillary Le Fort I osteotomy, wherein the anterior maxillary bone segment was retruded by 5 mm in the sagittal direction, vertically repositioned downward, and rotated clockwise (Fig. 10A). Closure of the right residual gap depends on anterior displacement of the bone mass (Figs. 10B and 11). 3D-printed occlusal plates were used to achieve precise intraoperative localization.
case_images: Intrasurgery photographs.
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case_images: F11
case_images: Closure of the right residual gap depends on anterior displacement of the bone mass (Figs. 10B and 11). 3D-printed occlusal plates were used to achieve precise intraoperative localization.
case_images: Three months postsurgery facial and intraoral photographs.
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case_images: F12
case_images: The esthetic appeal of the facial shape improved using 3D-printed occlusal plates, which enabled precise intraoperative localization after orthognathic surgery, with reduced maxillary convexity and a smooth chin line (Fig. 12).
case_images: CT reconstruction at the level of palate. (A) Presurgery, (B) immediately postsurgery, (C) 3 months postsurgery.
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case_images: F13
case_images: Soft and hard tissues healed well, and there was significant bone regeneration at 3 months postoperatively compared with the immediate postoperative period (Fig. 13).
case_images: Pre-prosthodontics intraoral photographs.
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case_images: F14
case_images: Furthermore, the remaining gap, except for that necessary for the prosthesis, was further closed, and the occlusion was subsequently refined (Fig. 14).
case_images: Pre-prosthodontics T scan. (A) Static occlusion, (B) anterior movement, (C) left lateral movement, (D) right lateral movement.
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case_images: F15
case_images: In this patient, extraction of the mesial incisors led to a compromised aesthetic appearance of the anterior teeth and occlusal interference during mandibular movements (Fig. 15, Video S1, Supplemental Digital Content, http://links.lww.com/MD/O296).