Orthognathic surgery-first approach with lingual appliances: a case report

Background A surgery-first approach has many advantages related to a shortened treatment time and an immediate facial aesthetic improvement compared to a three-stage conventional orthognathic surgery protocol. Objective The aim of this case report was to describe the treatment of a 21-year-old, female, patient who presented with a skeletal Class III malocclusion, maxillary retrusion, a negative overjet, an anterior and bilateral posterior cross-bite, and a vertical facial pattern highlighted by a high mandibular plane angle. Methods Orthodontic treatment was performed using self-ligating lingual appliances and a surgery-first approach. The active treatment time was 16 months. Results and conclusion Successful treatment results were achieved using a combination of an orthognathic surgery-first approach and lingual appliances in a patient with high aesthetic expectations.