Revisiting the Anterior Maxillary Subapical Osteotomy and Advancement Procedure

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Dentofacial Deformities

Background:

• Anterior maxillary subapical osteotomy (AMSO) is an orthognathic procedure infrequently used, often superseded by distraction osteogenesis (DO).
• AMSO is typically employed for cleft cases with anteroposterior maxillary deficiency.

Purpose of the Study:

• To describe the novel application of AMSO in a non-cleft maxillary deficiency case.
• To re-popularize AMSO by highlighting its ease, efficacy, reliability, and long-term stability.
• To present AMSO as a viable alternative for treating specific dentofacial deformities.

Main Methods:

• A case report detailing the use of AMSO for premaxillary advancement in a non-cleft patient.
• The technique was adapted as a case-specific approach.
• Consideration of a 'Surgery First, Orthodontics After (SFOA)' protocol modification.

Main Results:

• AMSO demonstrated simplicity, straightforwardness, and immediate esthetic outcomes.
• The procedure showed practically nil complication and relapse rates.
• Significant improvements in esthetics, speech, and mastication were observed post-surgery.

Conclusions:

• AMSO is an effective, reliable, and predictable procedure for premaxillary advancement.
• It offers advantages for mild to moderate Skeletal Class III dentofacial disharmony with anterior crossbite and reverse overjet.
• The 'Surgery First, Orthodontics After' approach can further expedite treatment and enhance patient compliance.