• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.375-379
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• 2010

Introduction: In the management of dentofacial deformities, variable movement of the maxilla can be made possible by a Le Fort I osteotomy. Posterior impaction of the maxilla necessary for rotation of the maxillomandibular complex enhances the functions and esthetic results. In cases of posterior impaction of the maxilla, an increase in the figure of the occlusal plane angle and incisor inclination can occur. This study reports the relationship between the amount of posterior impaction and the change in the occlusal plane angle and incisor inclination in a Le Fort I osteotomy by preoperative and postoperative lateral cephalograms. Materials and Methods: Twenty patients who had undergone orthognathic surgery in Dong-A University Medical Center participated in this study. Lateral cephalometrics, within 3 weeks prior to surgery and 3 days after surgery, were used for analysis. Pre and postoperative measurements of the occlusal plane angle and incisal inclination based on the Frankfort horizontal (FH) plane were performed. X and Y were defined as the amount of vertical change in the upper incisor tip and the amount of vertical change in the upper first molar mesial cup tip through the operation. The amount of final posterior maxillary impaction was determined by subtracting Y from X, which is the difference in vertical height. According to the amount of posterior maxillary impaction, the change in the occlusal plane angle and incisal inclination was measured. Results: The average posterior maxillary impaction was 2.91 mm and the average change in the occlusal plane angle and incisal inclination was $6.54^{\circ}$after surgery. As a result, each mm of posterior maxillary impaction changed the occlusal plane angle and incisal inclination by $2.25^{\circ}$. Statistically, there was high significance. Two cases were observed: one with the same amount of posterior maxillary impaction performed on both the right and left showing $2.20^{\circ}$, and the other with a different amount of posterior maxillary impaction performed showing $2.35^{\circ}$. In this case, there was no significance difference between the two cases. Conclusion: Each mm of posterior maxillary impaction changes the occlusal plane angle and incisal inclination by an average of $2.25^{\circ}$. In posterior maxillary impaction, there was no significant difference in the amount of change in the occlusal plane angle and incisal inclination regardless of whether there was an equal amount of posterior maxillary impaction on both sides. This study is expected to help in the presurgical orthodontic preparation and presurgical treatment planning.

• The Journal of the Korean dental association
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• v.53 no.7
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• pp.468-475
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• 2015

In cleft lip and palate (CLP) patients, there are various degree of residual maxillofacial deformities in adolescent period. Usually, orthoganthic surgery for the cleft patients needs Le Fort I osteotomy and/or mandibular set-back surgery. Previous report from other institute had been shown that there is significant relapse after maxillary movement after Le Fort I osteotomy when the surgical advancement of the maxilla was over than 5 or 7mm in average. Recent comphrehensive report showed that most of the relapse was happened within 1 year and the total horizontal relapse of the maxilla was as high as 30% in average. Therefore, overcorrection is needed in maxillary surgery for cleft patients. Another concerns for cleft orthognathic surgery is the anatomical variation in pterygomaxillary region in cleft patients compared to control patients. Patients with CLP had larger and thicker pterygomaxillary dimensions, and the results imply that careful attention to pterygomaxillary anatomy is needed in patients with CLP undergoing Le Fort I surgery. This article reviews the pre and postoperative considering factors for orthognathic surgery for CLP patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.255-260
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• 1989

Unfavorable healing of maxillary fractures may impose functional and esthetic burdens upon the trauma victim. Malunited maxillary fractures are generally a result of treatment delay, incomplete or inaccurate immobilization of the fracture fragments, or infection. Dysfunctions of mastication, distortions in speech, gross defects in facial contour, and related psychic changes are problems which may require secondary correction. When it is necessary to delay definitive treatment or when inadequate maxillary fracture reduction is recognized within the first week following injury, the maxilla can be mobilized by heavy handed dental manipulation under anesthesia or by elastic traction to an external fixation appliance attached to the maxilla by arch bars or an acrylic splint. But malunited maxillary fracture that have progressed to bony malunion require osteotomy procedure in order to establish normal anatomic relationships. This report parents two cases of malunited unilateral maxillary fracture surgically corrected by unilateral Le Fort I osteotomy.

• The Journal of the Korean dental association
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• v.47 no.6
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• pp.373-378
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• 2009

This article presents a modified palatal pedicled incision design in anterior segmental maxillary osteotomy. This method included the circumcrevicular incisions and two vertical relaxing incisions. Then, it is different from the Couper's method with vestibular horizontal incision and other anterior segmental osteotomy techniques. The main advantages of this method are an improved visibility of surgical field and favorable preservation of palatal pedicle. A patient who had been operated by anterior segmental maxillary and mandibular osteotomy without pre operative orthodontic treatment was analyzed for advantages and complications during the intraoperative and early post operative period. There are no specific major complications such as infection, gingival recession and dehiscence. And the patient had a pleasing esthetic facial appearance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.149-155
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• 1997

Ridge expansion osteotomy(REO) technique is a simple and more conservation method to widen a narrow alveolar ridge in the maxilla. This method is superior to drilling method in soft and narrow maxillary alveolar ridge and allows the surgeon to widen the ridge in routine office procedure. Therefore, it is the treatment of choice to implant the maxilla with narrow alveolar ridge. This article presents clinical cases and discusses the advantages, rationale and surgical protocol of REO technique.

• The Journal of the Korean dental association
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• v.34 no.3 s.322
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• pp.215-222
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• 1996

Ridge expansion osteotomy(REO) procedure is used to widen the narrow ridge in locations that are too thin to permit the use of standard implant drills. The objective of this technique is to maintain, if possible, all of the existing maxillary bone by pushing the bone aside with minimal trauma. The author has used tis procedure on five patients who had narrow ridge in their soft maxillary bone. Fifteen implants were placed in sites needing ridge expansion using REO. The satisfactory results were obtained. The REO procedure is thought to be a safer and more conservative method of widening a narrow ridge. And this procedure is heatless, offers excellent tactile sensitivity, control, visibility, and takes advantage of available bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.28.1-28.6
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• 2016

Backgrounds: Insufficient intermaxillary space is caused by non-restoration following tooth extraction in the past, and this involves eruption of the opposing teeth and changes of the arch structure. Such cases are difficult just by a simple prosthetic approach, and diversified treatment plans should be established. Among these, posterior maxillary segmental osteotomy (PMSO) is an efficient treatment option than extraction of opposing teeth as it surgically repositions multiple erupted teeth and alveolar bone. PMSO can preserve the natural teeth; therefore, it is being regarded as a treatment method which can improve insufficient intermaxillary space significantly. Case presentation: In this case report, the first patient received PMSO in order to place an implant in the mandibular edentulous space after decreased vertical dimension is restored, and the second patient received PMSO along with orthodontic treatment to obtain the intermaxillary space and balance the interarch molar width. Conclusion: PMSO is the treatment of choice when occlusion is compromised in the presence of decreased vertical dimension or arch length discrepancy.

• Journal of Korean Dental Science
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• v.13 no.2
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• pp.67-72
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• 2020

Purpose: This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. Materials and Methods: Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment. Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. Conclusion: Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.106-111
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• 2012

Purpose: The aim of this sturdy was to assess the prevalence and change in pathologic findings in the maxillary sinus by using preoperative and postoperative cone-beam computed tomography (CBCT). Methods: The subjects included 83 patients with maxillary sinus abnormalities who underwent orthognathic surgery between January 2010 to December 2010. The CBCT analyses were classified according to the thickness of maxillary sinus membrane; Normal (membrane thickness<2 mm), mucosal thickening (membrane thickness ${\geq}2mm$ and <6 mm), partial opacification (membrane thickness>6 mm but not complete), total opacification, and polypoidal mucosal thickening. The diameters of the maxillary sinus ostium on the coronal cross-sectional view were also calculated. Results: Out of 166 maxillary sinuses in 83 patients, 42 (25.3%) maxillary sinuses before surgery and 37 (22.3%) maxillary sinuses after surgery showed abnormalities. A decrease in the diameters of maxillary ostium was observed after surgery (P<0.05). However, there was no significant difference in mucosal thickness both, preoperatively and postoperatively. Conclusion: The orthognathic surgery didn't deteriorate the maxillary sinus abnormaility. Despite the low prevalence of sinus complications in orthognathic surgery, all the patients should be informed of the possibility of sinusitis that could require the surgical intervention before surgery.