Interdisciplinary treatment of complex multilevel gnathic malformation using the Face Airway Bite (FAB) concept – a case report

In recent years, interdisciplinary treatment and orthognathic surgery have become well established in the treatment of skeletal problems of the facial skeleton and associated malocclusions. The development of surgical techniques, planning methods supported by 3D technology, clinical observations and analyses of treatment outcomes have led to a change in approaches to interdisciplinary treatment, the primary goal of which used to be to obtain proper occlusal relations.

Aim
The article presents a case of a 34-year-old woman with a multilevel gnathic defect receiving orthodontic and surgical treatment according to the FAB concept (Face Airway Bite) proposed by G. William Arnett. At the treatment planning stage, we focused on improving parameters defining facial aesthetics according to soft tissue cephalometric analysis (STCA), managing airway dimensions, and achieving proper occlusion.

Case report
The article presents a case of a 34-year-old woman with a multilevel gnathic defect receiving interdisciplinary treatment including orthodontic and surgical treatment. The first stage required orthodontic decompensation. Then, surgical treatment was planned using NemoFAB software (Nemotec, Spain) and performed in a hospital ward setting. The final step included postoperative orthodontic treatment and adequate retention planning.

Results
Combined orthodontic-surgical treatment lasted seventeen months in this case. All planned treatment goals were achieved: improvement of facial aesthetics, smile, occlusion, and increased spatial dimensions of the upper airways at the level of the pharynx.

Summary
This case illustrates the application of the FAB concept in interdisciplinary treatment and confirms that it is an appropriate approach to plan and conduct interdisciplinary treatment of skeletal defects.