• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.319-324
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• 2009

Kole's Anterior segmental osteotomy of the mandible is commonly used to close an anterior open bite, to depress an elevated anterior dentoalveolar segment, or to retrude or advance a dentoalveolar segment. The procedure is often combined with an anterior maxillary segmental osteotomy to correct bimaxillary protrusion. We report 53-year-old woman who the extruded state of mandibular anterior alveolar segment was corrected using an mandibular anterior alveolar segmental osteotomy and dental implantation of the anterior maxilla. We planned to remove the old prosthesis, and then perform an anterior mandibular segmental osteotomy and implant restoration of the anterior maxilla. We suggest that anterior segmental osteotomy is very useful for rehabilitating edentulous patients with malaligned alveolar segment.

• The korean journal of orthodontics
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• v.39 no.1
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• pp.54-65
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• 2009

This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy(ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy(Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.124-129
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• 2013

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.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.2
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• pp.89-96
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• 2012

Le Fort 1 osteotomy or maxillary advancement with distraction osteogenesis (DO) is main treatment strategy for cleft palate patients with maxillary hypoplasia. Maxillary DO allows greater maxillary advancement within physiological limit than Le Fort 1 osteotomy. Moreover, it is better for velopharyngeal function. However, there is a greater tendency for an increase in nasal sound when maxilla is advanced excessively. Therefore, the advancement of anterior maxillary segment using DO has been utilized. It offers advantages such as an increase in the length of the palate, a prevention of the change in palatopharyngeal depth, and a preservation of the velopharyngeal function. Moreover, it will obliterate the necessity of bone graft, and it prevents the occurrence of oronasal or oroantral fistula. Finally, it stimulates the regeneration of the soft and hard tissue of alveolus, and subsequently makes possible to place implant.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.20.1-20.7
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• 2020

Background: Anterior open bite is a challenging malocclusion to correct orthodontic treatment. Anterior open bite associated with over-erupted posterior teeth and long lower facial height should be treated by reduction of posterior dimension for esthetic results. Although the possibility of orthodontic treatment of an anterior open bite has increased with the introduction of skeletal anchorage, there are still cases requiring surgery for various reasons. Case presentation: This case report covers an anterior open bite of a 25-year-old man successfully treated with the posterior maxillary segmental osteotomy (PMSO) and miniplates. After the pre-surgical orthodontic treatment, the PMSO between canines and first premolars was performed under local anesthesia and miniplates were placed on the zygomatic buttress. As a result of 28 months of treatment, an impaction amount of 3.5 mm was obtained in the maxillary posterior teeth, and the facial esthetics improved at rest and smile. Conclusion: The impaction of the posterior dentoalveolar segment using the PMSO can be a good treatment option in patients with anterior open bite showing long lower facial height.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.3
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• pp.74-80
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• 1990

This is to report a case of surgical and orthodontic of posterior scissor bite, deep bite and gummy smile by the segmental osteotomies. The surgical thechnics procedures used are Peterson's mandibular posterior segmental osteotomy, modified $K{\ddot{o}}le$ technic for mandibular anterior segment and Wunderer's maxillary anterior segmental osteotomy. The results are as follows : 1) Peterson's mandibular posterior segmental osteotomy could be achieved by the buccal approach with some difficulties in accessbility. 2) Upper and lower anterior segmental osteotomies were followed separately to correct the deep curve of Spee, deep bite and gummy smile in shortened period. 3) All alveolar segments were immobilized in preplanned position by the prefabricated palatal and lingual resin splint, therefore intermaxillary fixation was not necessary.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.324-335
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• 2020

Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.5
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• pp.217-223
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• 2013

Objectives: Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery. Materials and Methods: Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture. Results: Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible. Conclusion: Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.

• The korean journal of orthodontics
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• v.28 no.6 s.71
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• pp.975-979
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• 1998

Our Goal of modified segmental osteotomy on maxilla accompanied by mandibular anterior subapical osteotomy was to get the best results from patients of bi-alveolar or bi-maxillary protrusion. In this study, cephalometric and photo (en face, profile) analysis have been compared to define the soft tissue change after surgery. Lip protrusion was efficiently reduced and nasolabial angle was much obtused. Although nose was a little widened, it was quite acceptable. Blood circulation on osteotomized segment was well maintained. This relatively simple methods could be successfully applied to many patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.274-278
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• 2005

Purpose : Prediction for soft tissue change after orthognathic surgery is very important for the final esthetics. In this study, we have tried to get the amount of upper lip movement relative to bony segment movement after anterior segmental osteotomy by cephalmetric analysis to predict final upper lip position after surgery. Material and Methods : 20 patients was studied on whom anterior segmental osteotmy as performed by Cupar method during the years 2002 to 2003. Cephalometric radiograph were taken at 1month before surgery and 6 month after surgery. Change of upper lip was measured on landmark Ls and Sto relative to hard tissue (landmark Ia) setback on these X-rays and analyzed. Results : 1. Upper lip setback movement. Setback of upper lip showed proportional relation to the hard tissue setback and the ratio was about 84%(p=0.001). 2. Upper lip downward movement. Downward movement of upper lip showed no proportional relation to hard tissue setback And the amount was mean 1.38 mm and SD 1.21mm (p=0.922). Conclusion : The posterior movement of upper lip is affected by hard tissue movement and shows good proportional change whereas downward movement is not so much influenced by hard tissue movement. And we think slight downward movement shown in this study could be explained by the V-Y closure performed during surgery.