Retreatment using temporary anchorage device for a patient with relapse after orthognathic surgery: a case report

Introduction: Recently, orthodontic treatment using temporary anchorage devices (TADs) has advanced and developed to correct more severe occlusal and dentofacial discrepancies. The aim of this article is to use an innovative method using TADs for total mandibular arch distalization to establish the functional occlusion after relapse of orthognathic surgery. Case presentation: The patient was a 22-year-old man with a chief complaint of mandibular protrusion at the first visit. The diagnosis was skeletal and dental Class III malocclusion accompanied by retrusive maxilla and protrusive mandible. The crossbite and concave facial profile could be improved with the appropriate amount of mandibular set-back by mean of Le Fort I osteotomy and bilateral sagittal split ramus osteotomy (BSSO). However, occlusal relapse showing negative overjet was found 3 months after surgery. After TADs placed in the ramus, total mandibular arch distalization has started using them. Six months later, appropriate overjet and functional occlusion could be established and gained. Their course has been uneventful for 3 years since then. Clinical discussion: This retreatment could achieve the efficient results with maintained adjacent teeth positioning with less patient compliance. As a result, the mandibular anterior teeth were retracted about 3.0 mm with lingual inclinations. This technique for relapse in orthognathic surgery is rare in the literatures. Conclusion: Orthodontic treatment using TADs is easy to access and effective approach for the patients with for relapse in orthognathic surgery.