Poster 178: Stability of the Maxilla After Superior Repositioning With the Total Maxillary Alveolar Osteotomy

Abstract

Statement of the ProblemThe purpose of this study was to investigate the postoperative stability of the maxilla following the total maxillary alveolar osteotomy (TMAO) with rigid internal fixation.Materials and MethodsThe maxilla was osteotomized using buccal access. Two parallel horizontal osteotomies were placed facially from the piriform aperture to the maxillary tuberosity. The inferior osteotomy was placed 5mm above the apices of the front teeth, whereas the superior osteotomy was placed below the floor of the nose. After the intrusion of the dento-alveolar segment with removal of horseshoe-shaped bone block, fixation with four titanium or resorbable miniplates was made.Method of Data AnalysisIn order to assess the postoperative maxillary movement pattern in 51 patients (mean age 23.1) with both vertical maxillary excess and so-called gummy smile, lateral cephalograms were obtained immediately preoperatively, and 1 day, 1 year, and 2 years after surgery. The changes in point A of the maxilla were examined on the cephalograms.ResultsNo apparent postoperative complications were found. At 1-year and 2-year follow-up, no significant postoperative relapse in the examined point of the maxilla was found in the horizontal (0.5±0.6 mm, 0.4±0.4 mm mean anterior movement, respectively) and vertical (0.2±0.4 mm, 0.2±0.4 mm mean anterior movement, respectively) direction.ConclusionThese results suggest that TMAO might be a reliable and useful technique for superior repositioning of the maxilla with alveolar height excess and gummy smile. Statement of the ProblemThe purpose of this study was to investigate the postoperative stability of the maxilla following the total maxillary alveolar osteotomy (TMAO) with rigid internal fixation. The purpose of this study was to investigate the postoperative stability of the maxilla following the total maxillary alveolar osteotomy (TMAO) with rigid internal fixation. Materials and MethodsThe maxilla was osteotomized using buccal access. Two parallel horizontal osteotomies were placed facially from the piriform aperture to the maxillary tuberosity. The inferior osteotomy was placed 5mm above the apices of the front teeth, whereas the superior osteotomy was placed below the floor of the nose. After the intrusion of the dento-alveolar segment with removal of horseshoe-shaped bone block, fixation with four titanium or resorbable miniplates was made. The maxilla was osteotomized using buccal access. Two parallel horizontal osteotomies were placed facially from the piriform aperture to the maxillary tuberosity. The inferior osteotomy was placed 5mm above the apices of the front teeth, whereas the superior osteotomy was placed below the floor of the nose. After the intrusion of the dento-alveolar segment with removal of horseshoe-shaped bone block, fixation with four titanium or resorbable miniplates was made. Method of Data AnalysisIn order to assess the postoperative maxillary movement pattern in 51 patients (mean age 23.1) with both vertical maxillary excess and so-called gummy smile, lateral cephalograms were obtained immediately preoperatively, and 1 day, 1 year, and 2 years after surgery. The changes in point A of the maxilla were examined on the cephalograms. In order to assess the postoperative maxillary movement pattern in 51 patients (mean age 23.1) with both vertical maxillary excess and so-called gummy smile, lateral cephalograms were obtained immediately preoperatively, and 1 day, 1 year, and 2 years after surgery. The changes in point A of the maxilla were examined on the cephalograms. ResultsNo apparent postoperative complications were found. At 1-year and 2-year follow-up, no significant postoperative relapse in the examined point of the maxilla was found in the horizontal (0.5±0.6 mm, 0.4±0.4 mm mean anterior movement, respectively) and vertical (0.2±0.4 mm, 0.2±0.4 mm mean anterior movement, respectively) direction. No apparent postoperative complications were found. At 1-year and 2-year follow-up, no significant postoperative relapse in the examined point of the maxilla was found in the horizontal (0.5±0.6 mm, 0.4±0.4 mm mean anterior movement, respectively) and vertical (0.2±0.4 mm, 0.2±0.4 mm mean anterior movement, respectively) direction. ConclusionThese results suggest that TMAO might be a reliable and useful technique for superior repositioning of the maxilla with alveolar height excess and gummy smile. These results suggest that TMAO might be a reliable and useful technique for superior repositioning of the maxilla with alveolar height excess and gummy smile.