Orthognatic surgery in the edentulous patients

Aim. In the correct diagnosis of the skeletal/dental discrepancy and the subsequent surgical treatment dental arches play a very important role. Some adult patients, affected by maxillo-mandibular malformations, present a total or subtotal edentulia that makes more difficult the correct morpho-functional rehabilitation. The aim of this study is to show the problems we constantly deal with in the treatment of such patients. Methods. We selected 7 patients affected by a dento-skeletal class III with total or subtotal edentulia which undergone a Le Fort I osteotomy and a mandibular sagittal split osteotomy. The specimen has been evaluated by means of pre and postoperative standard examination (lateral cephalometric and panoramic radiographs and TMJ tomograms). Furthermore, for each patient, we performed a new prosthesis to obtain a correct occlusal stability during and after surgery. Results. Our experience demonstrated that the definitive treatment planning of double jaw surgery in edentulous class III patients is formulated on an appropriate skeletal evaluation because of the poor reliability of soft tissues. Besides, it is necessary to provide each patient of a prosthesis that establishes the new relationship between maxilla and mandible. Conclusion. Finally, we believe that definitive prosthetic rehabilitation or additional complementary procedures should be performed only after orthognatic surgery.