Abordagem de caso clínico de uma paciente com deformidade dento-esquelética do tipo Classe III, acompanhada de deficiência de proeminência zigomática. A Cirurgia Ortognática bimaxilar, com a colocação de biomaterial à base de polietileno poroso e mentoplastia compuseram o plano de tratamento. No pós-operatório, o uso de faixas fisioterápicas foi implantado para o controle do inchaço e prevenção de hematomas. A importância do apoio emocional e mental foi destacada para uma recuperação bem-sucedida, além da necessidade de planejamento cuidadoso e uma abordagem multiprofissional para garantir o melhor resultado possível. A confiança entre cirurgião e paciente, juntamente com a compreensão da complexidade não apenas da reabilitação de sua oclusão, mas também da sua autoestima, são aspectos cruciais a se considerar.
Autoria
person Maria Clara Furlaneto Heck
schoolDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, BrazilUniversity of São PauloBrazilMonte Alegre, São Paulo, BrazilDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, Brazil
person Thales Fabro Vanzela Sverzut
schoolDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, BrazilUniversity of São PauloBrazilMonte Alegre, São Paulo, BrazilDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, Brazil
person Alexandre Elias Trivellato
schoolDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, BrazilUniversity of São PauloBrazilMonte Alegre, São Paulo, BrazilDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, Brazil
person Cássio Edvard Sverzut
schoolDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, BrazilUniversity of São PauloBrazilMonte Alegre, São Paulo, BrazilDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, Brazil
Correspondence: Professor Cássio Edvard Sverzut; Department of Oral and Maxillofacial Surgery and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo 14040‑904, Brazil. E-mail:
cesve@forp.usp.br
cesve@forp.usp.br
Responsible Editor
Manoel Damião de Sousa-Neto
SCIMAGO INSTITUTIONS RANKINGS
Department of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, BrazilUniversity of São PauloBrazilMonte Alegre, São Paulo, BrazilDepartment of Oral and Maxillofacial Surgery and Trauma and Periodontics - School of Dentistry of Ribeirão Preto of the University of São Paulo, Avenida Do Café, s/n, Monte Alegre, Ribeirão Preto, São Paulo14040‑904, Brazil
Figuras
imageopen_in_new

imageFigure 1 Preoperative facial images: A) Frontal view showing maxillary vertical excess resulting in lip incompetence; B) Frontal smiling view showing a remarkable gummy smile; C) Lateral view showing the deficiency of the zygomatic bone prominence and increased chin projection. open_in_new

imageFigure 2 Preoperative dental images: A) Right side showing the canine and first molar class III relation; B) frontal view showing the anterior teeth touching top to top and the misalignment of the dental midlines; C) Left side showing the canine and first molar class III relation. open_in_new

imageFigure 3 Intraoperative images: A) The Le Fort I osteotomy fixed with 1.5mm fixation system; B) The alloplastic biomaterial on the right side fixed with two 1.5mm screws; C) The alloplastic biomaterial on the left side fixed with two 1.5mm screws; D) Mentoplasty fixed with two positional screws from the 2.0mm system. open_in_new

imageFigure 4 The adaptation of the porous polyethylene biomaterial on the 3D printed prototype after being immersed in hot saline water, making it malleable. open_in_new

imageFigure 5 Patient in the recovery room with physiotherapy tapes strategically positioned, aiming to control edema and prevent hematomas. open_in_new

imageFigure 6 Postoperative facial images 22 months after the surgery: A) Frontal view showing an adequate balance between the facial thirds and the passive lips closure; B) Frontal smiling view showing an adequate gum exposure; C) Lateral view showing adequate zygomatic bone prominence and chin projection. open_in_new

imageFigure 7 Postoperative dental images 22 months after the surgery: A) Right side showing the canine and first molar class I relation; B) frontal view showing an adequate overbite and relation between the dental arches and a misalignment of the dental midlines; C) Left side showing the canine and first molar class I relation. open_in_new

imageFigure 8 Lateral cephalometric radiograph: A) Preoperative and, B) Twenty-two months after the surgical procedure. open_in_new

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E-mail: bdj@forp.usp.br
E-mail: bdj@forp.usp.br
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