上下顎同時骨延長術を施行した著しい垂直的上顎劣成長を伴う下顎前突症の1例

Abstract

When maxillary downgraft is performed for patients with severe maxillary deficiency, postoperative stability is sometimes insufficient. We report a case of mandibular protrusion with excessive vertical maxillary deficiency treated with simultaneous maxillo-mandibular distraction osteogenesis using alveolar distractors.A 25-year-old male patient visited our orthodontic clinic for treatment of his chief complaint that his upper incisors were invisible upon smiling. Upon examination, he was diagnosed as mandibular overgrowth with excessive vertical maxillary deficiency. Simultaneous maxillo-mandibular distraction osteogenesis was performed for considerable downward movement of the maxilla. Le Fort I osteotomy and bilateral inverted L osteotomy of the mandible were performed under general anesthesia. Bilateral alveolar distractors were set to the maxilla. After maxillo-mandibular fixation, distraction osteogenesis was performed downward by 10.5mm. Although slight relapse occurred 1 year after surgery and the final total amount of distraction was 9.0mm, the facial height and profile were improved and adequate exposure of the upper incisors was obtained.