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Surgical procedures for correcting vertical maxillary excess: A review.
Nisrina Ekayani Nasrun1, Shigehiro Takeda1, Yasuhito Minamida2
1Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan.
International Journal of Surgery Case Reports
|September 10, 2021
Summary
Modified Le Fort I osteotomies in Japan show promising results for correcting vertical maxillary excess. These surgical techniques, including horseshoe and U-shaped osteotomies, minimize complications and achieve stable, predictable outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Craniofacial Surgery
Background:
- Vertical maxillary excess is a common orthodontic issue causing facial deformities and open bites.
- Le Fort I osteotomy is a surgical solution, but carries risks like descending palatine artery (DPA) injury.
- Limited research exists on Le Fort I osteotomy modifications in Japan.
Purpose of the Study:
- To review modifications of Le Fort I osteotomy performed in Japan.
- To assess the safety and efficacy of these modified techniques.
Main Methods:
- A literature review was conducted on Le Fort I osteotomy modifications: horseshoe, modified horseshoe, unilateral horseshoe, pyramidal, and U-shaped osteotomies.
- Eight studies from Japan involving 77 patients (aged ≥17) with vertical maxillary excess were analyzed.
Main Results:
- No severe intra- or post-operative complications were reported with the modified Le Fort I osteotomies.
- Maxillary repositioning was accurate and stable for at least 12 months post-surgery.
- Preserving the DPA was associated with reduced complication rates.
Conclusions:
- Modified Le Fort I osteotomies are safe and effective for treating vertical maxillary excess in the Japanese population.
- Techniques like horseshoe and U-shaped osteotomies offer distinct advantages for specific patient needs.
- These modifications contribute to predictable and stable long-term results in orthognathic surgery.
