Bi-jaw Surgical Correction of Skeletal Class III Malocclusion with Anterior Open Bite using “Minimal Presurgical Orthodontic” Approach, a 12-month Follow-up Case Report

Background: Traditional orthognathic surgery typically requires prolonged and extensive orthodontic treatment prior to surgery, followed by a shorter postoperative orthodontic phase. The pre-surgical orthodontic period is lengthy and can lead to a decline in facial aesthetics due to decompensation. Consequently, patients’ mental health could decline and they could lose confidence as a result of these changes. To address the issue of deteriorating facial soft tissues during early decompensation and to reduce the risk of unstable postoperative occlusion, the surgery-first approach (SFA) or minimal pre-surgical orthodontics (MPO) has been introduced. MPO is designed to minimize occlusal interference and enhance arch coordination for surgery, thereby increasing the predictability of surgical outcomes.Case Description: An 18-year-old male patient with skeletal class III malocclusion and an anterior open bite was treated using MPO. A modified trans-palatal arch (TPA) was applied before surgery to rectify a projected post-surgical buccal scissor-bite involving the maxillary second molar. After achieving this correction, the patient underwent bi-jaw surgery.Conclusion: This approach, in contrast to the conventional method, involved brief orthodontic tooth movement without negatively impacting the patient’s profile or decompensation. The patient was highly satisfied and delighted with the outcome.