A Case of Severe Unilateral Scissors Bite Treated by Application of Orthognathic Surgery

Abstract

Unilateral scissors bite is a rare malocclusion that results in functional problems. Orthognathic surgery is a possible solution for the patient in order to reduce the discomfort during the upright period of the posterior segment.
The subject was a 12-year and 1-month-old male who expressed the chief complaint of dysmasesis caused by a scissors bite on the right side. The medical history revealed an autistic tendency and communication handicap. Overerupted upper-right premolars and molars, and linguo-inclined lower-right premolars and molars were indicated in the initial records. Orthognathic surgery was performed after the patient had mentally matured, which took about 3 years. Prior to the operation, all third molars were extracted under general anesthesia. The following surgical correction on the right side was first carried out: 1. Upper-right posterior segmental osteotomy, 2. Sagittal splitting ramus osteotomy (right side), and 3. Mandibular body step osteotomy (right side). A good interdigitation in the posterior segment on the right side was established by the following multibracket appliance in order to reduce the risk of post-operative change.
After 2 years and 3 months of active treatment involving orthognathic surgery, retention was started. The treatment aims have been achieved, both in terms of addressing the patient's concerns and in establishing a fairly good functional occlusion.