CHALLENGES IN PLANNING AND OCCLUSAL STABILITY IN CLASS III ORTHOGNATHIC SURGERY

Abstract

Skeletal Class III malocclusion is considered one of the most therapeutically complex dentofacial deformities, characterized by anteroposterior discrepancy between the maxilla and mandible, with significant aesthetic and functional impacts (ALHAMMADI et al., 2022; OWENS et al., 2024). In adult patients with moderate to severe discrepancies, orthognathic surgery is the treatment of choice, as it improves facial profile, masticatory function, and phonation (ALHAMMADI et al., 2022; LATHROP-MARSHALL et al., 2022). This study aims to analyze the challenges related to planning and occlusal stability in orthognathic surgery for Class III patients, through a narrative literature review conducted in the PubMed database, encompassing articles published in the last five years. Literature demonstrates that therapeutic success depends on careful planning, adequate orthodontic decompensation, and precise surgical execution (LIU et al., 2021). Three-dimensional digital planning and the use of 3D-printed surgical guides have increased predictability and precision in skeletal repositioning (NGUYEN; NGUYEN, 2024). However, factors such as the magnitude of bone movements, alveolar thickness, presence of cleft lip and palate, and possible condylar alterations can influence postoperative stability and favor relapses (GAO et al., 2025; FARIA-TEIXEIRA et al., 2024; ROMAN et al., 2022). Furthermore, functional adaptation, especially related to speech, is a relevant criterion in evaluating the results (LATHROP-MARSHALL et al., 2022). It is concluded that occlusal stability in patients with skeletal Class III malocclusion is directly related to the integration of accurate diagnosis, individualized orthodontic-surgical planning, and rigorous postoperative follow-up, making a multidisciplinary approach indispensable for achieving stable and lasting results.