Restorative Correction of an Overshot Mandible (Class III Skeletal Correction)
One visit. No pain. No injections. An affordable dental facelift.
A 19-year-old university student presented with a prominent lower jaw that affected her dentofacial appearance. In her words, “the face just doesn’t look right”. She had consulted numerous orthodontists and maxillofacial surgeons, all of whom recommended orthognathic surgery with prolonged orthodontic treatment and repositioning of her deeply impacted canines. While we agree this is the ideal treatment, the estimated cost of $90,000 AUD and the disruption to her university life made it unrealistic at this stage. She needed a simpler, more immediate and affordable solution that would leave the ideal treatment option open for the future.
Chief Concerns:
- Prominent lower jaw affecting dentofacial appearance
- Worn upper deciduous canines
- Deeply impacted permanent canines
- Advised jaw corrective surgery and prolonged orthodontics, not viable at age 19
- Reduced confidence without being able to pinpoint why
Diagnosis
Treatment is facially driven, not dentally. It is all about the face. Projecting to the face, the diagnosis was:
- Class III skeletal pattern with an overshot lower jaw (mandible)
- Concave facial profile
- Reduced lower facial volume
- Narrow upper arch
- Worn upper deciduous canines
- Unwanted jawline outline
Treatment Approach
The correct diagnosis was the solution. Rather than surgery, we corrected the facial scaffold to restore lower facial support. The Class III skeletal correction was completed in a single visit, with no pain and no injections. The bite was opened using direct composite to restore lower facial volume, and expansion of the maxilla provided optimal scaffolding for the face.
Treatment Outcome:
- Narrow upper arch: corrected
- Overshot prognathic mandible: corrected
- Concave facial profile corrected to a straighter, more convex outline
- Reduced lower facial volume corrected through opening the bite with direct composite
- Reduced nasolabial folds from expansion of the upper arch
- Improved lower facial height, jawline, lip support and profile
- More harmonious facial outline
- Improved patient confidence
Aftercare and Maintenance
Experience and expertise are essential to achieving an optimal outcome and reducing the risk of retreatment. Patients are advised to follow a strict treatment protocol and maintain post-treatment retention. Six-monthly assessments help reduce risk, depending on individual risk assessment.
About the Clinician
Prosthodontist & Implant Surgeon
B.D.S. (Hons), Dip. Clin. Dent. (Oral Implants) Uni Syd, M. Clin. Dent (Prosth) King’s College, Uni London
D. Clin. Dent (Prosth) Uni Syd, FRACDS, MRACD (Prosth)