RESUMO A combinação da terapia ortodôntica com a cirurgia ortognática é uma modalidade de tratamento bem estabelecida para a correção de deformidades dentofaciais. Quando estas deformidades apresentam maior severidade, envolvendo a hipoplasia do terço médio da face, exigem técnicas cirúrgicas não utilizadas como rotina no tratamento das alterações faciais, como a osteotomias Le Fort III ou as variações destas técnicas. Poucos estudos relatam o uso desta técnica ou de suas modificações em pacientes não sindrômicos. Este trabalho tem como objetivo demonstrar uma resolução ortodôntica-cirúrgica de um paciente apresentando deformidade de face com má-oclusão Classe III severa, envolvendo hipoplasia do terço médio facial, com a realização de uma técnica modificada da osteotomia Le Fort III, associada as osteotomias Le Fort I e osteotomia sagital dos ramos mandibulares. O paciente encontra-se com três anos de acompanhamento pós-operatório, com melhora significativa na sua habilidade mastigatória, sem queixas funcionais, relatando alta satisfação com a estética e melhora na qualidade de vida.

ABSTRACT The combination of orthodontic therapy and orthognathic surgery is a well-established treatment modality for the correction of dentofacial deformities. When these deformities are more severe, involving hypoplastic midface, surgical techniques not used routinely in the treatment of facial changes are required, such as the Le Fort III osteotomy or variations of this technique. Few studies have reported the use of this technique or its modifications in non-syndromic patients. This paper demonstrates the orthodontic-surgical resolution of a patient with dentofacial deformity with severe malocclusion Class III, involving midface hypoplasia, with a modification technique of a Le Fort III osteotomy associated with Le Fort I and sagittal of the rami osteotomies. After three years of postoperative follow-up, the patient demonstrates significant improvement in chewing ability, no functional complaints, and high satisfaction with the aesthetics and improved quality of life.

Aim: To evaluate the prevalence of intraoperative accidents associated with extraction of third molars and identify possible risk factors. Methods: Prospective study with patients undergoing third molar surgery by residents of the Oral and Maxillofacial Surgery Service at the Federal University of Parana. Epidemiological data were collected from preoperative evaluation forms. During the surgical procedure were evaluated the radiographic position classifications of all third molars removed, using methods such as osteotomy and/or tooth section, time for the procedure and occurrence of any complication. Results: The students extracted a total of 323 teeth. The mean surgical time was 45 min. Conclusions: The prevalence of intraoperative accidents during extraction of third molars was 6.19%. The most prevalent accident was maxillary tuberosity fracture, followed by hemorrhage. Age, positioning of the teeth and use of the techniques of osteotomy and tooth section are possible risk factors.