Anterior maxillary osteotomy: A technical note for superior repositioning: A bird wing segment

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Surgical Innovation

Background:

• Anterior maxillary osteotomy (AMO) is a common procedure for correcting vertical maxillary excess.
• Conventional AMO bone removal can be time-consuming and may risk palatal pedicle compromise.
• Improving surgical efficiency and safety in AMO is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of a novel 'bird wing' osteotomy segment during AMO.
• To assess the impact of this technique on surgical duration and palatal pedicle perfusion.
• To determine the long-term stability and patient satisfaction with the bird wing technique.

Main Methods:

• A prospective study involving 20 patients (8 male, 12 female, mean age 25-30) with vertical maxillary excess.
• Presurgical orthodontics and clinical assessment guided the calculated superior repositioning.
• The bird wing segment technique was employed during the anterior maxillary osteotomy procedure.

Main Results:

• The bird wing technique reduced bone removal time by approximately 50% compared to conventional methods.
• All patients maintained pulp vitality and exhibited minimal edema post-surgery.
• Excellent aesthetic results and patient satisfaction were reported, with no relapse or bite changes observed up to 1 year.

Conclusions:

• The bird wing osteotomy segment is an effective modification for AMO, significantly shortening surgical time.
• This technique minimizes the risk of palatal pedicle kinking, ensuring good anterior segment perfusion.
• The procedure offers predictable outcomes, stability, and high patient satisfaction in managing vertical maxillary excess.