medigraphic.com
ISSN 2395-9215 (Print)
Órgano Oficial de Difusión de la Facultad de Odontología de la UNAM

2013, Number 1

<< Back Next >>

Rev Mex Ortodon 2013; 1 (1)

Skeletal class III correction by advancing and descending the maxilla with a bone graft Case report

Ortiz SJD, Guzmán VI

Language: Spanish
References: 14
Page: 55-61
PDF size: 540.51 Kb.


ABSTRACT

Class III malocclusion can involve a lot of factors such as excessive mandibular growth, deficient maxillary growth, other environmental factors and maxillary trauma. The correction of this malocclusion can be with orthodontic treatment (camouflage) and when there is a more significant bone discrepancy, esthetic or functional problems; it can be solved with a combination of orthodontic-surgical treatment. In this case report, a 17-year-old patient with a dental and maxillofacial deformity (Angle class III malocclusion) due to a deficient vertical and sagittal maxillary growth, with no transverse discrepancy; excessive mandibular growth, brachyfacial with concave profile, a 1 mm incisor display when smiling which had a major impact on the patient’s aesthetic perception of herself. An orthodontic-surgical treatment was planned using Roth 0.018” x 0.025” slot appliances. The surgical treatment was a maxillary inferior repositioning and advancement using an autogenous chin graft. Maxillary segmentation was performed to coordinate both arches. Le Fort I surgery is an effective procedure in the correction of dentofacial discrepancies with maxillary deficiency. The aesthetic and functional results obtained by using this type of surgery were successful and treatment was continued with post-surgical-orthodontic treatment to get a detailed finishing of the case. Conclusion: Maxillary repositioning is used nowadays to achieve long term stability in the correction of class III skeletal discrepancies, when in the past the only solution was to treat with mandibular surgery only, thus producing poor facial aesthetics.


REFERENCES

  1. Proffit William. Ortodoncia contemporánea teoría y práctica. 3rd ed. Madrid, España: Editorial Harcourt; 2001.

  2. Gurstein KW et al. Stability after inferior or anterior maxillary repositioning by Le Fort I osteotomy: a biplanar stereocephalometric study. Int J Adult Orthodon Orthognath Surg. 1998; 13 (2): 131-43.

  3. McLaughlin RP et al. Mecánica sistematizada del tratamiento ortodóncico. Madrid, España: Elsevier; 2002.

  4. Baker RW, Subtelny JD, Iranpour B. Correction of a class III mandibular prognathism and asymmetry through orthodontics and orthognathic surgery. Am J Orthod Dentofac Orthop. 1991; 99 (3): 191-201.

  5. Perez MM, Sameshima GT, Sinclair PM. The long-term stability of Le Fort I maxillary downgrafts with rigid fixation to correct vertical maxillary deficiency. Am J Orthod Dentofac Orthop. 1997; 112 (1): 104-108.

  6. Bothur S, Blomavist JE, Isaksson S. Stability of Le Fort I osteotomy with advancement: a comparison of single maxillary surgery and a two-jaw procedure. J Oral Maxillofac Surg. 1998; 56 (9): 1029-1033.

  7. Miguel JA et al. Long term stability of two-jaw surgery for treatment of mandibular deficiency and vertical maxillary excess. Int J Adult Orthodon Orthognath Surg. 1995; 10 (4): 235-245.

  8. Wagner S, Reyneke JP. The Le Fort I downsliding osteotomy: a study of long-term hard tissue stability. Int J Adult Orthodon Orthognath Surg. 2000; 15 (1): 37-49.

  9. Jünger TH, Krenkel C, Howaldt HP. Le Fort I sliding osteotomy–a procedure for stable inferior repositioning of the maxilla. J Craniomaxillofac Surg. 2003; 31 (2): 92-96.

  10. Mehra P et al. Stability of the Le Fort I osteotomy for maxillary advancement using rigid fixation and porous block

  11. hidroxiapatite grafting. Oral Surg Oral Med Oral Path. 2002; 94 (1): 18-23.

  12. Egbert M et al. Stability of Le Fort I osteotomy with maxillary advancement: a comparison of combined wire fixation and rigid fixation. J Oral Maxillofac Surg. 1995; 53 (3): 243-248.

  13. Chow J, Hägg U, Tideman H. The stability of segmentalized Le Fort I osteotomies with miniplate fixation in patients with maxillary hypolplasia. J Oral Maxillofac Surg. 1995; 53 (12): 1407-1412.

  14. Mol Van Otterloo JJ et al. Inferior positioning of the maxilla by a Le Fort I osteotomy: a review of 25 patients with vertical maxillary deficiency. J Craniomaxillofac Surg. 1996; 24 (2): 69-77.




2020     |     www.medigraphic.com