The role of orthognathic surgery in the treatment of severe dentoalveolar extrusion

Background. When mandibular molars are not replaced after extraction, the l ong-term problem of inadequate interarch space for either a fixed or remova ble prosthesis can occur. In the past, practitioners needed to decide wheth er to shorten the teeth, extract the supererupted maxillary molars to recap ture space or leave the area unrestored. The authors present another option . Case Description, A 61-year-old man was referred to a periodontist by his g eneral dentist for placement of mandibular implants in the posterior sextan t. Extreme supereruption of the maxillary dentoalveolar segment prevented r estoration of the opposing edentulous area. An oral and maxillofacial surge on performed a segmental osteotomy of the posterior right maxilla to gain n eeded interarch space. After the osteotomy was stabilized, the periodontist placed implants that were subsequently restored with a fixed prosthesis. Clinical Implications. The role of orthognathic surgery in treatment planni ng should not be overlooked in the comprehensive management of severe extru sion. It offers patients the opportunity to gain both function and esthetic s that might otherwise be impossible.