ABSTRACT

A 19-year-old female patient with skeletal Class III malocclusion, a great number of missing teeth, hyperactive mentalis muscle, and a severely concave facial profile presented for treatment. Treatment objectives were to align the arches, restore the gingival health in the mandibular anterior region, and achieve better facial esthetics. A lip release procedure was undertaken to lower the forces exerted by the mentalis muscle to the lower incisor teeth. Gingival grafts were placed before the surgery to restore and maintain the attached gingiva. Maxillomandibular advancement surgery as well as genioplasty to decrease the chin projection which would increase as a result of mandibular advancement was performed. Active treatment time was 33 months. Posttreatment evaluation revealed that most of the treatment objectives had been achieved. In this case report, the use of lip release and free gingival grafting procedures as an adjunct to orthognathic treatment is presented.