CASE REPORT tion. An upper wrap-around retainer was used, but is not shown here. A full lower wrap-around retainer is used to close the band space in the lower molar area. Once this is done, one would hardly know that there are no lower six-year molars present. These pictures were taken some 22 years after we started the case. She has a slightly prominent chin button, but it does not detract from her appear-ance. As stated earlier if one wishes, a genioplastic surgical procedure can be done in the oral surgeons office, to move the chin button back. This surgical procedure does not affect the temporal mandibular joints; where as surgically sectioning the mandible on both sides, whether lengthening or retract-ing the jaw has to be put back together. Getting the condyles back in the fossae in the correct position while the mandible is screwed back together is very difficult to do, if not impossible. Fig. 11 shows the teeth 22 years after starting. These pictures were taken in 2010. This patient has been seen frequantly in my office since the finishing of her case. Nearly 25 years after start-ing the case her teeth look virtu-ally the same. Note the upper wisdom teeth are still present, and the lower arch looks like someone has removed the lower wisdom teeth. In this type of treatment the temporal mandibu-lar joints have not been molested. The teeth and joints are very stable, as evidenced by their condition over 20 years out of treatment. I strongly recom-mend this type of treatment for many moderately severe class III cases. It takes a little longer to do, but when one considers the cost and risk of the surgery itself, and the possibility of dysfunc-tional temporal mandibular joints after the surgery, it is well worth that little additional time. Fig. 9 Fig. 10 Fig. 11 www.orthodontics.com March/April 2013 23
Journal of the American Orthodontic Society March-April 2013: Page 23
