Nasomaxillary hypoplasia with a congenitally missing tooth treated with LeFort II osteotomy, autotransplantation, and nickel-titanium alloy wire

• The LeFort II osteotomy is the efficient method for improving nasomaxillary hypoplasia.
• A lower eyelid subciliary incision created a cosmetically acceptable result.
• Tooth autotransplantation combined with the improved superelastic wire technique is an effective treatment.

IntroductionIn some skeletal Class III adult patients with nasomaxillary hypoplasia, the LeFort I osteotomy provides insufficient correction. This case report describes a 20-year-old woman with a combination of nasomaxillary hypoplasia and a protrusive mandible with a congenitally missing mandibular second premolar.MethodsWe performed a LeFort II osteotomy for maxillary advancement. Autotransplantation of a tooth was also performed; the donor tooth was used to replace the missing permanent tooth. To increase the chance of success, we applied light continuous force with an improved superelastic nickel-titanium alloy wire technique before extraction and after transplantation.ResultsThe patient's profile and malocclusion were corrected, and the autotransplanted tooth functioned well. The postero-occlusal relationships were improved, and ideal overbite and overjet relationships were achieved.ConclusionsThe methods used in this case represent a remarkable treatment.