Posterior Segmental Osteotomy Research Articles

Unilateral condylar hyperplasia treated with simultaneous 2-jaw orthognathic surgery and posterior segmental osteotomy.

A 25-year-old woman presented with left condylar hyperplasia, canting-type facial asymmetry, mandibular prognathism, and arch width discrepancy. Bone scintigraphy confirmed the inactive status of the condyle, and the temporomandibular joint functioned within the normal range; thus, orthognathic surgery without condylectomy was performed. To correct facial asymmetry successfully through orthognathic surgery, sufficient dentoalveolar decompensation must be achieved in the presurgical orthodontic phase. In cases of canting-type facial asymmetry, teeth on the nondeviated side are extruded as dentoalveolar compensation. Therefore, vertical decompensation is required for intrusion of the extruded teeth. A miniscrew and resin build-ups were used for the intrusion of teeth, and posterior segmental osteotomy was simultaneously performed with orthognathic surgery for further intrusion. The canting-type facial asymmetry was notably corrected through successful vertical decompensation and close cooperation between orthodontists and maxillofacial surgeons. After 2 years of retention, the treatment results remained stable.

Surgical treatment of unilateral severe overeruption and opposing alveolar atrophy.

Overeruption with simultaneous alveolar deficiency is not uncommon but very difficult to treat. In mild cases of overeruption without opposing alveolar deficiency, selective removal of enamel from the overerupted teeth may be an option, yet not advocated. Extraction of the overerupted teeth should be avoided if the teeth are intact with sufficient bone support. The Schuchardt operation is a good option for cases limited to the overeruption. In cases of overeruption with simultaneous opposed alveolar deficiency, it is suggested to perform simultaneous maxillary and mandibular surgical procedures: alveolar segmental operation, followed by a sandwich osteotomy on the opposing arch. This article presents a posterior segmental osteotomy in the maxilla and a simultaneous sandwich procedure in the mandible utilizing the bone graft removed from the maxilla. The results showed good functional and esthetic outcomes. This method preserves the native teeth. It also utilizes an autogenous bone graft that is harvested regardless of the interpositional graft and spares a second surgical site. In addition, it allows for a one-stage procedure which enables for both treatment of the overeruption and augmentation of the opposing arch.

Posterior Maxillary Segmental Osteotomy Concomitant With Sinus Lift Using a Piezoelectric Device

Tooth loss evokes functional and esthetic problems, and adjacent teeth can move if they are not corrected in a timely manner, rendering the problems of restoring the dentition more complex. If the opposing tooth is consequently extruded, several treatment modalities may be adopted, such as occlusal adjustment, crown prosthesis, orthodontic treatment, and segmental osteotomy. Segmental osteotomy is the most aggressive and invasive treatment for restoring a problematic occlusal plane due to the complications, such as hemorrhage, loss of tooth vitality, or necrosis of the segment. Piezoelectric devices have recently been used in oral surgery and implant dentistry because they preserve the soft tissue. In this report, we describe a bilateral posterior segmental osteotomy procedure to correct a collapsed occlusal plane with sinus mucosa elevation, using piezoelectric devices to preserve the integrity of the sinus membrane and the posterior superior alveolar artery.

著しい片側性きょう状こう合を顎矯正手術の併用により治療した１例

Unilateral scissors bite is a rare malocclusion that results in functional problems. Orthognathic surgery is a possible solution for the patient in order to reduce the discomfort during the upright period of the posterior segment.The subject was a 12-year and 1-month-old male who expressed the chief complaint of dysmasesis caused by a scissors bite on the right side. The medical history revealed an autistic tendency and communication handicap. Overerupted upper-right premolars and molars, and linguo-inclined lower-right premolars and molars were indicated in the initial records. Orthognathic surgery was performed after the patient had mentally matured, which took about 3 years. Prior to the operation, all third molars were extracted under general anesthesia. The following surgical correction on the right side was first carried out: 1. Upper-right posterior segmental osteotomy, 2. Sagittal splitting ramus osteotomy (right side), and 3. Mandibular body step osteotomy (right side). A good interdigitation in the posterior segment on the right side was established by the following multibracket appliance in order to reduce the risk of post-operative change.After 2 years and 3 months of active treatment involving orthognathic surgery, retention was started. The treatment aims have been achieved, both in terms of addressing the patient's concerns and in establishing a fairly good functional occlusion.

Posterior segmental osteotomy of maxillary edentulous ridge: an alternative to vertical reduction

Abstract. The posterior segmental maxillary osteotomy (PSMO) can be used as an alternative procedure to vertical reduction of the edentulous posterior maxilla. Surgical intrusion of the segment resulted in an adequate interarch space for prosthetic restoration without cortical bone loss and widening of the edentulous ridge and the mobilized keratinized mucosa as would be the case if vertical alveolar reduction had been performed.

Vascularity of the dental pulp after segmental osteotomy in the chacma baboon ( Papio ursinus)

Objective — To assess the vascularity of the dental pulp after segmental operations with and without interpositional autogenous bone grafting. Design — Experimental study. Setting — University Department, South Africa. Animals — 26 chacma baboons. Interventions — Maxillary and mandibular posterior segmental osteotomies were perfused with barium sulphate 3, 6, 12 and 18 months postoperatively. The animals were killed at 3, 6, 12 and 18 months after surgery and perfused with barium sulphate. Barium-filled vessels were counted in histological sections from 189 control and experimental teeth. Main outcome measure — Number of blood vessels. Results — Blood vessel counts in mandibular teeth in osteotomy segments ranged from 0 to 1.15 compared with 2.27 to 4.58 in control teeth, while in maxillary teeth counts ranged from 0.54 to 2.22 for experimental teeth and 3.3 to 4.65 for controls. For both jaws, the numbers of vessels in experimental teeth gradually increased between 3 and 18 months but remained less than those in control teeth. Numbers of blood vessels were similar in graft and no-graft groups but both were less than half the counts in control teeth. Conclusion — Blood flow is present in the teeth at all times after posterior segmental osteotomy but there is a risk of ischaemia.

臼歯部歯槽骨切り術によってこう合改善した１例

This is a case report on treatment of skeletal psalidodont deformity with simultaneous maxillary and mandibular posterior segmental osteotomy. Operation was performed through only buccal mucosal incision for the preservation of blood supply to the osteotomized segments and the fixation of fragments were done using acrylic resin splint without using miniplate-screwing to avoid injuring the tooth root. Soon after the operation, temporary segmental mobility was observed. However, the usually reported postoperative complications such as relapse and disturbance of the segment or the teeth were not remarkable. Finally. the fine occlusal relationship and function were obtained.

Maxillary Anterior and Posterior Segmental Osteotomy for Correction of Skeletal Open Bite

We reported a case of skeletal anterior open bite deformity treated with both maxillary anterior and posterior segmental osteotomies. The clinical and radiographic examinations indicated a stable result without relapse. Maxillary posterior segmental osteotomy for skeletal anterior open bite is an effective procedure that could correct the etiological sequence of altered mandibular protrusion, forward tongue posture, and buccal segment extrusion. In addition, combination with maxillary anterior segmental osteotomy shorten the duration of treatment.

Maxillary Posterior Segmental Osteotomy for Correction of Skeletal Open Bite

The treatment of skeletal anterior open bite deformity using the single-stage maxillary posterior segmental osteotomy has been followed for 5 years to evaluate the final outcome of the operation. The clinical and radiographic examination during the control period show a remarkable stable result without a relapse. Treatment planning based on clinical, ceahalometric, dental plaster model examination and tongue posture analysis allows the accurate and predictable correction of this deformity. In addition, tongue posture had shifted from anteriorly and superiorly to posteriorly and inferiorly after surgery. The stable occlusion and this improvement of tongue posture after maxillary posteriorly segmental osteotomy is an effective surgical procedure for the skeletal open bite.

Le Fort I Osteotomy and Posterior Maxillary Segmental Osteotomy for Correction of Malunioned Maxilla

This is a case report of correction of malunioned maxilla after traffic accident by Le Fort I osteotomy and posterior segmental osteotomy. By this procedure, authors obtained the following results. 1. The malinioned maxilla after traffic accident which had anterior crossbite, posterior open bite and scissor's bite were corrected by Le Fort I osteotomy and posterior segmental osteotomy. 2. No postoperative infection and specific complication were seen in this case. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. And then, the patient could open his mouth in normal range after a week of intermaxillary fixation removal. 4. For rigid fixation and reducing relapse, the osteotomized maxilla was fixed with miniplates.