Surgical correction of vertical maxillary excess associated with mandibular self-rotation

The Class I skeletal deformity associated with vertical maxillary excess is a rare condition reported in the literature. Surgical impaction allows the correction of the long face and gummy smile. Objective: This case report aimed to evaluate the positioning of the condyle after Le Fort I osteotomy associated with mandibular selfrotation. Case report: The patient underwent orthognathic surgery for the correction of maxillary vertical excess. Tomography studies were performed to evaluate the initial and final position of the condyle. The patient improved mastication, breathing and phonetics, with esthetic benefit. Conclusion: After the Le Fort I osteotomy and mandibular self-rotation, the condyle remained stable occupying a new anterior-superior position in the glenoid fossa and patient’s TMJ remained asymptomatic after 9 months of postoperative follow-up.

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Surgical correction of vertical maxillary excess associated with mandibular self-rotation

RSBO ◽

10.21726/rsbo.v1i1.387 ◽

2017 ◽

Vol 1 (1) ◽

pp. 56 ◽

Cited By ~ 1

Author(s):

Michelle Nascimento Meger ◽

Fernanda Tiboni ◽

Felipe Silvério Dos Santos ◽

Thalyta Verbicaro ◽

Tatiana Miranda Deliberador ◽

...

Keyword(s):

Case Report ◽

Orthognathic Surgery ◽

Rare Condition ◽

Final Position ◽

Le Fort I Osteotomy ◽

Skeletal Deformity ◽

Le Fort ◽

Le Fort I ◽

Gummy Smile

Introduction: The Class I skeletal deformity associated with vertical maxillary excess is a rare condition reported in the literature. Surgical impaction allows the correction of the long face and gummy smile. Objective: This case report aimed to evaluate the positioning of the condyle after Le Fort I osteotomy associated with mandibular selfrotation. Case report: The patient underwent orthognathic surgery for the correction of maxillary vertical excess. Tomography studies were performed to evaluate the initial and final position of the condyle. The patient improved mastication, breathing and phonetics, with esthetic benefit. Conclusion: After the Le Fort I osteotomy and mandibular self-rotation, the condyle remained stable occupying a new anterior-superior position in the glenoid fossa and patient’s TMJremained asymptomatic after 9 months of postoperative follow-up.

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Correction of gummy smile by superior repositioning of maxilla in Bangladeshi people

Bangladesh Journal of Orthodontics and Dentofacial Orthopedics ◽

10.3329/bjodfo.v6i1.42395 ◽

2016 ◽

pp. 1-5

Author(s):

Abdullah Al Masud ◽

Muhammad Shohag Shikder ◽

Mohammad Tofazzal Hossan ◽

Mohammad Mahfuzul Gani ◽

Mohammad Wahidul Islam

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Class I ◽

Class Ii Malocclusion ◽

Le Fort I Osteotomy ◽

Le Fort ◽

Le Fort I ◽

Gummy Smile

Vertical maxillary excess is associated with gummy smile, incompetent lip, bimaxillary proclination, Angle’s class-I or class-II malocclusion with or without retogenia. After proper evaluation preoperative orthodontic treatment was performed in every cases and superior repositioning of the maxilla by Le Fort-I osteotomy is presented. Three patients with maxillary excess associated with retrogenia or microgenia were treated with this technique in combination with genioplasty. The maxillary segment was repositioned a maximum of 7.0 mm superiorly at point A. The mandible autorotated anterosuperiorly to achieve sound occlusion. Point B moved 1.0–3.0 mm anteriorly and 5.0–8.0 mm superiorly. The pogonion moved 4.0 mm anteriorly in a case done without genioplasty and the pogonion moved maximum 8.0mm in case done in combination with genioplasty. All patients obtained sound occlusion and a good profile after the operation. Almost no skeletal relapse was observed during 3 years of postoperative follow-up. Amount of gingiva showing during smile was ranges from 5.0mm –7.0mm which was 0-2.0mm after superior repositioning of the maxilla. Ban J Orthod & Dentofac Orthop, April 2016; Vol-6 (1-2), P.1-5

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Le Fort I osteotomy facilitated nasotracheal intubation in a patient with concha bullosa and septal deviation: a case report

10.22514/sv.2021.062 ◽

2021 ◽

Keyword(s):

Case Report ◽

Nasal Cavity ◽

Orthognathic Surgery ◽

Nasotracheal Intubation ◽

Maxillofacial Surgery ◽

Septal Deviation ◽

Concha Bullosa ◽

Le Fort I Osteotomy ◽

Le Fort ◽

Le Fort I

Introduction: Nasotracheal intubation (NTI) is preferred for general anesthesia in maxillofacial surgery. However, NTI is often traumatic or even unsuccessful, particularly in patients with a narrow nasal pathway. In this case report, we describe a less traumatic NTI approach using maxillary downfracture of Le Fort I osteotomy. Case presentation: A 19-year-old woman was admitted with a skeletal Class III malocclusion and scheduled to undergo bimaxillary orthognathic surgery. A preoperative evaluation revealed no other medical history and abnormal laboratory findings. Preoperative computed tomography showed nasal septal deviation, concha bullosa, and turbinate hypertrophy. A nasal Ring-Adair-Elwyn endotracheal tube and a tube exchanger could not be inserted via NTI because of her narrow nasal cavity. An oral intubation was performed temporarily and surgery was started. After a maxillary downfracture was performed, which made the nasal cavity wider than before, NTI was successfully conducted without difficulty. The patient was ventilated without any problems, and the operation was continued. Postoperatively, the patient had no further complications and her vital parameters were all stable. Conclusions: This case report suggests that NTI after maxillary downfracture of Le Fort I osteotomy can be a good alternative that can be successfully performed with less trauma in patients undergoing orthognathic surgery who are preoperatively evaluated as having a narrow nasal cavity.

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Massive epistaxis due to pseudoaneurysm of the sphenopalatine artery: a rare post-operative complication of orthognathic surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215113000819 ◽

2013 ◽

Vol 127 (6) ◽

pp. 610-613 ◽

Cited By ~ 11

Author(s):

Y-W Kim ◽

M-J Baek ◽

H-D Kim ◽

K-S Cho

Keyword(s):

Computed Tomography ◽

Case Report ◽

Literature Review ◽

Orthognathic Surgery ◽

Le Fort I Osteotomy ◽

Le Fort ◽

Sphenopalatine Artery ◽

Life Threatening ◽

History Of ◽

Le Fort I

AbstractObjective:To introduce pseudoaneurysm of the sphenopalatine artery as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy.Methods:Case report and literature review.Results:This paper reports a case of acute life-threatening epistaxis following Le Fort I osteotomy. Computed tomography and angiography showed a pseudoaneurysm of the sphenopalatine artery, which was successfully treated by endovascular embolisation.Conclusion:Although a pseudoaneurysm of the sphenopalatine artery following Le Fort I osteotomy is extremely rare, it should be considered as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy.

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Modified Le Fort I Osteotomy and Genioplasty for Management of Severe Dentofacial Deformity in β-Thalassaemia Major: Case report and review of the literature

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2020.20.03.018 ◽

2020 ◽

Vol 20 (3) ◽

pp. 362

Author(s):

Khamis M. Al Hasani ◽

Abdulaziz A. Bakathir ◽

Ahmed K. Al-Hashmi ◽

Badar Al Rawahi ◽

Abdullah Albakri

Keyword(s):

Case Report ◽

Maxillofacial Surgery ◽

Severe Anaemia ◽

University Hospital ◽

Thalassaemia Major ◽

Le Fort I Osteotomy ◽

Skeletal Deformity ◽

Le Fort ◽

Dentofacial Deformities ◽

Le Fort I

β-thalassaemia major is an autosomal recessive form of haemoglobinopathy that is characterised by complete lack of production of the β-chains resulting in multiple complications that include severe anaemia, failure to thrive and skeletal abnormalities. Facial deformities induced by β-thalassaemia major are rare and are very challenging to treat from a surgical point of view. We report a 33-year-old female patient with β-thalassaemia major who presented to the Dental & Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with gross dentofacial skeletal deformity contributing to her psychosocial issues. The facial deformity was corrected surgically by excision of the enlarged maxilla, modified Le Fort I osteotomy and advancement genioplasty. This case highlights the pre-operative preparation, surgical management, encountered complications and treatment outcome within 24 months of follow-up.Keywords: Beta-Thalassaemia; Thalassaemia Major; Cooley's Anemia; Le Fort Osteotomy; Genioplasty; Dentofacial Deformities; Case Report; Oman.

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An idiopathic delayed maxillary hemorrhage after orthognathic surgery with Le Fort I osteotomy: a case report

Journal of the Korean Association of Oral and Maxillofacial Surgeons ◽

10.5125/jkaoms.2019.45.6.364 ◽

2019 ◽

Vol 45 (6) ◽

pp. 364

Author(s):

Byungho Park ◽

Wan-Hee Jang ◽

Bu-Kyu Lee

Keyword(s):

Case Report ◽

Orthognathic Surgery ◽

Le Fort I Osteotomy ◽

Le Fort ◽

Le Fort I

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W-Shaped Osteotomy to Avoid Paranasal Deformity After Standard Le Fort I in Orthognathic Surgery

Plastic Surgery ◽

10.1177/2292550320969655 ◽

2020 ◽

pp. 229255032096965

Author(s):

Mario Santagata ◽

Nicola Sgaramella ◽

Fabrizio Chirico ◽

Salvatore D’Amato ◽

Ivo Ferrieri ◽

...

Keyword(s):

Orthognathic Surgery ◽

Preliminary Report ◽

Le Fort I Osteotomy ◽

Maxillary Bone ◽

Le Fort ◽

First Time ◽

Le Fort I ◽

Pyriform Aperture

When occlusal alterations are not accompanied by paranasal deficiencies, mobilization of the maxilla via Le Fort I osteotomy should be made with a different design. In this preliminary report, a W-shaped osteotomy that doesn’t change the position of the maxillary bone surrounding the pyriform aperture was presented for the first time. Advantages and indications of this new procedure are discussed.

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