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http://dx.doi.org/10.14402/jkamprs.2013.35.2.124

Surgical and Orthognathic Treatment of Skeletal Class III Featuring Severe Transversal and Sagittal Discrepancy: A Case Report  

Ryu, Kyung-Sun (Department of Oral and Maxillofacial Surgery, Kyung Hee University School of Dentistry)
Lee, Baek-Soo (Department of Oral and Maxillofacial Surgery, Kyung Hee University School of Dentistry)
Kim, Yeo-Gab (Department of Oral and Maxillofacial Surgery, Kyung Hee University School of Dentistry)
Kwon, Yong-Dae (Department of Oral and Maxillofacial Surgery, Kyung Hee University School of Dentistry)
Choi, Byung-Joon (Department of Oral and Maxillofacial Surgery, Kyung Hee University School of Dentistry)
Ohe, Joo-Young (Department of Oral and Maxillofacial Surgery, Kyung Hee University School of Dentistry)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.35, no.2, 2013 , pp. 124-129 More about this Journal
Abstract
Multiple segment osteotomy orthognathic surgery serves to combine the total or segmental maxillary and mandibular correction of the dentofacial deformities with concurrent procedures to provide immediate repositioning to the dento-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to the mandible or the facial skeleton by realigning the maxillary arch. In this case, the discrepancy in a bimaxillary horizontal relationship and the space between the 2nd premolar and 2nd molar was retained after lengthy preoperative orthodontic treatment. However, we could correct these dento-osseous discrepancies immediately by performing midpalatal expansion, anterior segmental osteotomy and symphyseal osteotomy with bimaxillary osteotomies. If the blood supply to each segment segments was maintained and primary closure of the operation site was feasible, multiple segment osteotomy was considered as a very effective technique for treating dentofacial deformities in vertical, transverse, and sagittal dimensions with differential repositioning of all segments.
Keywords
Orthognathic surgery; Palatal expansion; Anterior segmental osteotomy; Symphyseal osteotomy;
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1 Steel BJ, Cope MR. Unusual and rare complications of orthognathic surgery: a literature review. J Oral Maxillofac Surg 2012;70:1678-91.   DOI   ScienceOn
2 Farrell BB, Tucker MR. Safe, efficient, and cost-effective orthognathic surgery in the outpatient setting. J Oral Maxillofac Surg 2009;67:2064-71.   DOI   ScienceOn
3 Proffit WR, Phillips C, Turvey TA. Stability after mandibular setback: mandible-only versus 2-jaw surgery. J Oral Maxillofac Surg 2012;70:e408-14.   DOI   ScienceOn
4 Chen YR, Yeow VK. Multiple-segment osteotomy in maxillofacial surgery. Plast Reconstr Surg 1999;104:381-8.   DOI   ScienceOn
5 Kretschmer WB, Baciut G, Baciut M, Zoder W, Wangerin K. Transverse stability of 3-piece Le Fort I osteotomies. J Oral Maxillofac Surg 2011;69:861-9.   DOI   ScienceOn
6 Kretschmer WB, Baciut G, Bacuit M, Zoder W, Wangerin K. Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures. Br J Oral Maxillofac Surg 2010;48:276-80.   DOI   ScienceOn
7 Marchetti C, Pironi M, Bianchi A, Musci A. Surgically assisted rapid palatal expansion vs. segmental Le Fort I osteotomy: transverse stability over a 2-year period. J Craniomaxillofac Surg 2009;37:74-8.   DOI   ScienceOn
8 Bell WH. Revascularization and bone healing after anterior maxillary osteotomy: a study using adult rhesus monkeys. J Oral Surg 1969;27:249-55.
9 Bell WH, Levy BM. Revascularization and bone healing after anterior mandibular osteotomy. J Oral Surg 1970;28:196-203.
10 Bell WH. Immediate surgical repositioning of one- and two-tooth dento-osseous segments. Int J Oral Surg 1973;2:265-72.   DOI
11 Bell WH, Fonseca RJ, Kenneky JW, Levy BM. Bone healing and revascularization after total maxillary osteotomy. J Oral Surg 1975;33:253-60.
12 Lanigan DT, Mintz SM. Complications of surgically assisted rapid palatal expansion: review of the literature and report of a case. J Oral Maxillofac Surg 2002;60:104-10.   DOI   ScienceOn
13 Betts NJ, Sturtz DH, Aldrich DA. Treatment of transverse (width) discrepancies in patients who require isolated mandibular surgery: the case for maxillary expansion. J Oral Maxillofac Surg 2004;62:361-4.   DOI   ScienceOn
14 Ware WH, Ashamalla M. Pulpal response following anterior maxillary osteotomy. Am J Orthod 1971;60:156-64.   DOI   ScienceOn
15 Meyer MW, Cavanaugh GD. Blood flow changes after orthognathic surgery: maxillary and mandibular subapical osteotomy. J Oral Surg 1976;34:495-501.
16 Nelson RL, Path MG, Ogle RG, Waite DE, Meyer MW. Quantitation of blood flow after Le Fort I osteotomy. J Oral Surg 1977;35:10-6.
17 Siebert JW, Angrigiani C, McCarthy JG, Longaker MT. Blood supply of the Le Fort I maxillary segment: an anatomic study. Plast Reconstr Surg 1997;100:843-51.   DOI
18 Castelli WA, Nasjleti CE, Diaz-Perez R. Interruption of the arterial inferior alveolar flow and its effects on mandibular collateral circulation and dental tissues. J Dent Res 1975;54:708-15.   DOI   ScienceOn
19 Ho MW, Boyle MA, Cooper JC, Dodd MD, Richardson D. Surgical complications of segmental Le Fort I osteotomy. Br J Oral Maxillofac Surg 2011;49:562-6.   DOI   ScienceOn
20 de Mol van Otterloo JJ, Tuinzing DB, Greebe RB, van der Kwast WA. Intra- and early postoperative complications of the Le Fort I osteotomy. A retrospective study on 410 cases. J Craniomaxillofac Surg 1991;19:217-22.   DOI
21 Morgan TA, Fridrich KL. Effects of the multiple-piece maxillary osteotomy on the periodontium. Int J Adult Orthodon Orthognath Surg 2001;16:255-65.