Case 18

Adult (permanent dentition)

Problems

Abnormal sagittal co-ordination of the jaws

Retrognathic maxilla & prognathic and asymmetric mandible

Anterior and posterior cross-bites

Reduced upper lip projection in profile view

Severe mentalis muscle strain to close the mouth

Inability to close the mouth spontaneously due to the severe skeletal problem

Treatment

Orthodontic treatment with fixed appliances

Orthognathic surgery

Surgical interventions: Bimaxillary surgery