Indications and procedures for segmental dentoalveolar osteotomy: a review of 13 patients

The authors evaluated the surgical area, indications, and procedures for segmental dentoalveolar osteotomy carried out on 16 jaws in 13 patients treated at the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, between 1990 and 2001. Osteotomy was indicated mainly in cases where tooth repositioning by orthodontic treatment was limited, where social conditions (e.g., age, time, finances) precluded orthodontic treatment, or where revision of orthodontic or surgical treatment was required. In cases of maxillary anterior segmental dentoalveolar osteotomy, the modified Wunderer method was used, where after an incision was made in the palatal mucosa, a mucoperiosteal flap was abraded as much as possible until the area of the osteotomy on the palatal side could be visualized. In maxillary posterior segmental dentoalveolar osteotomy, the operation was carried out in 2 stages because of the risk of necrosis of the bone fragments. In the first stage, an osteotomy was carried out on the vestibular side, since the vestibular gingival pedicle was intact. In the second stage, 3 weeks later, another osteotomy was performed after the palatal mucoperiosteal flap was abraded to visualize the area of the osteotomy as well as that of the maxillary anterior segmental dentoalveolar osteotomy.