The patient underwent combined orthodonticorthognathic surgical treatment due to her
skeletal Class III malocclusion. In the first phase, orthodontic decompensation was
performed with maxillary and mandibular fixed appliances. The maxillary first premolars
were extracted; the created space was closed by anterior retraction. The posterior
anchorage was reinforced with interradicular temporary anchorage devices. In the second
phase, a digital surgical treatment plan was made with intra- and extraoral simulation
(including occlusion and profile). During the orthognathic surgery, a bilateral sagittal
split osteotomy with mandibular setback was combined with maxillary movements, using
3D-printed surgical splints. In the third phase, the orthodontic treatment continued
to finish and settle the occlusion. Spaces were created between the upper incisors
for ceramic veneers to gain proper overjet and occlusion. The last phase was prosthetic
and esthetic rehabilitation. During the planning, a 2Dand 3D-smile design was created
and presented to the patient as a mock-up. After digital impression and design, four
E-max veneers were milled and cemented using dual cement to finish the workflow. Retention
splints were created to preserve the new status as a final step.
