[Posterior hypsomaxilla: diagnostic and therapeutic considerations]

Posterior maxillary excess is a well individualized dento-alveolar anomaly which distorts the maxillary occlusal plane and induces clockwise rotation of the mandible. The dysmorphosis issued from is a skeletal open bite syndrome without dento-labial dysharmony. Surgico-orthodontic combined management is the adequate therapeutic procedure, on the following stages: during youth, a dento-facial orthopedic treatment is attempted to control posterior alveolar growth; pre-surgical alignment of teeth by orthodontic means correcting sagittal and transversal dental dystopies; surgical correction of the sole posterior hypsomaxilly is carried out by SCHUCHARDT osteotomy. In case of associated maxillary anomalies, LEFORT I osteotomy is indicated, mobilising the hole maxillary plate; post-surgical orthodontic affinement of final occlusion. When no orthodontic treatment had been effectuated, the prosthodontist will act for obtaining maximal dental intercuspidation; the plastic surgeon will harmonize facial profile, if needed.