Comprehensive treatment approach for condylar hyperplasia and mandibular crowding with custom lingual braces and 2-jaw surgery

We report on the successful treatment of a 32-year-old woman with condylar hyperplasia and severe mandibular crowding. In addition, her maxilla was canted to the right, her mandibular midline and chin point deviated to the left, and her maxillary canines were missing. The treatment plan included (1) aligning and leveling the teeth in both arches, (2) correcting overbite and overjet, (3) performing LeFort I osteotomy and bilateral split osteotomies, and (4) correcting the malocclusion postsurgically. The orthodontic treatment was performed with custom lingual braces and clear brackets, and virtual surgical planning techniques were used to plan the orthognathic surgery. The condylar hyperplasia and the mandibular crowding were corrected. At the end of treatment, the patient's face appeared symmetrical. The results suggest that esthetic and functional results can be achieved with the cooperation of 2 specialties and the use of state-of-the-art technology.