Case Report on Surgery-First Approach

The RationaleThe surgery-first approach provides immediate improvement in facial aesthetics in orthognathic cases with a shorter total treatment period. Patient ConcernsA 21-year-old male came with the chief complaint of protrusive lower front teeth and a large lower jaw. His main concern was aesthetics. DiagnosisThis was a case of skeletal Class III malocclusion with reverse overjet of 4 mm, overbite of 6 mm with a concave profile, and a protrusive chin. TreatmentThe patient was treated by bilateral sagittal split setback osteotomy of the mandible with surgery first approach via nonextraction therapy. OutcomeAfter an active treatment of 15 months, improved facial profile, facial proportions, and a significant reduction of mandibular prognathism were much appreciated. The treatment results were stable after a 1-year follow-up of the treatment. Take-away LessonThis case report highlights the utilization of nature's dental decompensation to achieve a desirable result, thereby attaining "more with less."