Management of Skeletal Class III Malocclusion due to Mandibular Prognathism Coexisting with Vertical Maxillary Excess

This case report describes combined orthodontic and orthognathic management of skeletal Class III malocclusion in a female patient presenting with prognathic mandible, increased maxillary height, severe hyperdivergence, gummy smile, and upper anterior proclination. Presurgical orthodontics involved extraction of maxillary first premolars and decompensating the proclined upper incisors. Orthognathic surgery involving differential maxillary impaction, mandibular bilateral sagittal split osteotomy setback, and sliding genioplasty. Postsurgical orthodontics was initiated one month after the surgery to finish the case in Class II molar relationship and Class I canine relationship with proper intercuspation. The outcome had acceptable results with good esthetics and occlusion