A Rehabilitation of Missing Maxillary Anterior Teeth in a Severe Skeletal Class III Malocclusion Patient Requiring Implants


  • Zethy Hanum Mohamed Kassim Universiti Teknologi MARA
  • Abdul Latif Abdul Hamid Columbia Asia Medical Centre, Seremban, Negeri Sembilan Malaysia
  • Nadhirah Ghazali Restorative Department, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Malaysia.
  • Puvanendran Balasingham Private Practice, Pristine Dental Centre, Wilayah Persekutuan, Kuala Lumpur




Class III malocclusion, Decompensation, Orthognathic, Implants, Prosthesis


Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion, treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic rehabilitation of the missing teeth using an i-FDP.


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Author Biography

Zethy Hanum Mohamed Kassim, Universiti Teknologi MARA

Dr Zethy Hanum Mohamed Kassim graduated with Bachelor of Dental Surgery from University of Malaya in 2005. She pursued clinical training in the field of Prosthodontics at the Eastman Dental Institute and obtained Masters in Clinical Dentistry (Prosthodontics) from University College London, United Kingdom in 2011. She received a Fellowship in Advanced Periodontology and Implantology from the University of Genoa, Italy in 2016. Her expertise is in rehabilitation of patients with worn, mutilated or missing teeth with conventional and implant restorations. She is registered with the National Specialist Register, Malaysia as a specialist in Prosthodontics since 2012. She served as the Head of Implant Unit (2014-2017) and Head of Restorative Dentistry (2017-2018) at the Dental Faculty, Universiti Teknologi MARA. Apart from active clinical work, she is involved in the teaching of undergraduate and postgraduate students. She has edited and contributed articles in journals and textbook and is actively involved in undergraduate and postgraduate research work.


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Case Report