The characteristics of modern society's trauma is a propensity for multiple and severe trauma, specially, the fatal damage accompanied by facial bone fracture. We observed the malocclusion owing to delayed prompt treatment If the fractured fragments is crushed severely, it is difficult to make them positioned into the normal anatomical states and to fix them tightly. Post-traumatic malocclusion is usually caused by a delay in treatment and inadequate anatomic reduction. Inadequately treated facial bone fractures result in facial disfiguring and functional impairment of mastication and speech.We performed 27 cases of correction of post-traumatic malocclusion between April 1994 and June 1996. We used various operative techniques such as anterior segmental osteotomy, Le Fort osteotomy, maxillary segmental osteotomy and mandibular sagittal split osteotomy. If the malocclusion was due to disarrangement segmental osteotomy. If that malocclusion was attributed to a malpositioned skeletal bone, we take maxillary segmental osteotomy or mandibular sagittal split osteotomy. We acquired the desirable occlusion first followed by a fixation between the mandible and maxillary skeletal bones with the bite block. The aim in the correction of malocclusion was to create a harmony of centric relation and centric occlusion. After operation, intermaxillary fixation with bite block have many advantages in the treatment of malocclusion.
Centric Relation ; Facial Bones ; Malocclusion* ; Mandible ; Mastication ; Maxillary Osteotomy ; Osteotomy ; Osteotomy, Le Fort

OBJECTIVETo investigate the orthodontic retention and adjustment of the occlusion after orthognathic surgery.

METHODS18 patients were divided into three groups. Group I: Cases with skeletal Class I bimaxillary protrusion treated by subapical osteotomy; Group II: Cases with skeletal Class II mandibular retrusion treated by sagittal split mandibular advancement surgery; Group III: Cases with skeletal Class III treated by Le Fort I osteotomy on maxilla and sagittal split osteotomy on mandible. There were 6 patients in each group. Three kinds of orthodontic elastic tractions were used based on different categories of malocclusion and different types of operation.

RESULTS18 patients attained functional occlusion after the orthodontic occlusion adjustment. There was no relapse and malocclusion by surgery.

CONCLUSIONIntermaxillary elastics based on different categories of occlusion and different kinds of surgery can improve the occlusion after orthognathic surgery and attatin the functional occlusion.

Adult ; Cephalometry ; Dental Occlusion ; Humans ; Male ; Malocclusion ; Mandible ; Maxilla ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Le Fort

Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Osteotomy* ; Osteotomy, Le Fort ; Palatal Expansion Technique* ; Recurrence* ; Salvage Therapy

BACKGROUND: Maxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients. METHODS: Eighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B. RESULTS: No patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B. CONCLUSIONS: Repaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.
Cleft Lip ; Cleft Palate ; Humans ; Mass Screening ; Maxilla ; Osteotomy ; Osteotomy, Le Fort ; Palate ; Velopharyngeal Insufficiency

The lacrimal drainage system begins at the puncta and empties through the valve of Hasner into the inferior meatus. The varieties of the anatomic location, size and morphology of this valve can predispose susceptible individuals to an increased incidence of iatrogenic injury during nasal surgical procedures, thus necessitating a comprehensive understanding of the system. We report two cases of epiphora following two-jaw surgeries for cosmetic purposes. Nasolacrimal duct obstructions were diagnosed, and the symptoms were improved with dacryocystorhinostomies.
Dacryocystorhinostomy ; Drainage ; Incidence ; Lacrimal Apparatus Diseases* ; Nasal Surgical Procedures ; Nasolacrimal Duct ; Osteotomy* ; Osteotomy, Le Fort

The contemporary two-jaw surgical approach usually involves a Le Fort osteotomy of the maxilla and a ramal osteotomy of the mandible with 3-dimensional repositioning of the jaws as well as the occlusal planes. After making the surgical treatment plan, the surgical movements are duplicated in the model surgery. During this procedure, reference points and lines are drawn on the base of the models over the dental arch, and sawcuts are made according to these marked osteotomy lines. This technique, however, has been found to be inexact, especially when the jaws are moved in several dimensions simultaneously. To overcome this, different methods have been developed for an accurate repositioning of the jaws as planned. A new appliance, Surgical Jaw Relator, has been devised by the author for the simple 3-dimensional relocation of the upper and lower models, resulting in the easy construction of the splints such as centric relation splint, intermediate and final splint. This article describes an introduction and a clinical application of this appliance. Through the application of this system to the orthognathic cases including two-jaw surgery, it is proved that the new device is very clinically useful.
Centric Relation ; Dental Arch ; Dental Occlusion ; Jaw* ; Mandible ; Maxilla ; Osteotomy ; Osteotomy, Le Fort ; Splints

Trauma in the modern society is characterized by multiple injuries, and the several comorbidities are often accompanied by facial bone fracture. The types of multiple facial bone fractures vary from Le Fort to panfacial fracture. Le Fort fracture, which can cause problems, such as facial disfigurement, functional impairment of mastication, malocclusion and speech abnormalities, is a challenging case for plastic surgeons. The purpose of treatment for patients with malocclusion due to Le Fort fracture is to maintain and restore both function and aesthetics. The author reports a case of Le Fort I osteotomy as a surgical correction of traumatic class III malocclusion due to Le Fort III fracture.
Comorbidity ; Esthetics ; Facial Bones ; Humans ; Malocclusion ; Mastication ; Multiple Trauma ; Osteotomy ; Osteotomy, Le Fort ; Plastics ; Surgeons

osteotomy(SSRO), intraoral vertical ramus osteotomy(IVRO), inverted L osteotomy, Le Fort I osteotomy. Difference of two groups was analyzed and compared statistically. The results were no difference between patients and RP model statistically. In surgical methods, IVRO was better similar results than other methods. RP model is useful in selection of surgery method and prediction of surgery. In facial asymmetry, we knew that IVRO in mandibular surgery is better method than others.]]>
Diagnosis ; Facial Asymmetry ; Humans ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Le Fort ; Skull

Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically.RESULTS: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the 1st molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the 1st molar. In particular, the IRP-C was changed in accordance with the canine.CONCLUSION: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.]]>
Congenital Abnormalities ; Dentofacial Deformities ; Humans ; Maxilla ; Molar ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Le Fort ; Vertical Dimension

Le Fort I osteotomy (with or without additional posterior maxillary impaction). The cone beam computed tomography was obtained before surgery (T0), 3~4 days after surgery (T1), and 6 months after surgery (T2). The surgical changes as well as the relapse of reference points in relation to the reference planes were statistically analyzed.RESULTS: The mean maxillary setback was 2.35 mm. There were posterior movements of A-point (0.73+/-0.83 mm) during T2-T1. An opening of the nasolabial angle (mean 12.58degrees) was noted.CONCLUSION: Total maxillary setback allows combining satisfactory functional and cosmetic results for a number of carefully selected patients.]]>
Cone-Beam Computed Tomography ; Cosmetics ; Humans ; Maxilla ; Osteotomy ; Osteotomy, Le Fort ; Recurrence