Maxillary sinus infection following Le Fort I osteotomy is rare in patients without a history of preexisting nasal symptoms. A case of a 19-year-old male patient who suffered from preoperative chronic non-allergic rhinitis and developed repetitive postoperative maxillary sinus infection after Le Fort I osteotomy is reported.]]>
Humans ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Osteotomy ; Rhinitis ; Young Adult

BACKGROUND: The Le Fort I osteotomy is one of the most widely used and useful procedure to correct the dentofacial deformities of the midface. The changes of the maxilla position affect to overlying soft tissue including the nasal structure. Postoperative nasal septum deviation is a rare and unpredicted outcome after the surgery. There are only a few reports reporting the management of this complication. CASE PRESENTATION: In our department, three cases of the postoperative nasal septum deviation after the Le Fort I osteotomy had been experienced. Via limited intraoral circumvestibular incision, anterior maxilla, the nasal floor, and the anterior aspect of the septum were exposed. The cartilaginous part of the nasal septum was resected and repositioned to the midline and the anterior nasal spine was recontoured. Alar cinch suture performed again to prevent the sides of nostrils from flaring outwards. After the procedure, nasal septum deviation was corrected and the esthetic outcomes were favorable. CONCLUSION: Careful extubation, intraoperative management of nasal septum, and meticulous examination of pre-existing nasal septum deviation is important to avoid postoperative nasal septum deviation. If it existed after the maxillary osteotomy, septum repositioning technique of the current report can successfully correct the postoperative septal deviation.
Dentofacial Deformities ; Maxilla ; Maxillary Osteotomy ; Nasal Septum ; Osteotomy* ; Spine ; Sutures

OBJECTIVES: This study sought to evaluate fixation methods and determine the best method for the postoperative stabilization of maxillary osteotomy. For our analysis we performed a three-dimensional finite element analysis of stress distribution on the plate, screw, and surrounding bone, as well as displacement onto the plate. MATERIALS AND METHODS: We generated a model using synthetic skull scan data; an initital surface model was changed to a solid model using software. Modified anterior segmental osteotomy (using Park's method) was made using the program, and four different types of fixation methods were used. An anterior load of 100 N was applied on the palatal surface of two central incisors. RESULTS: The Type 1 (L-shaped) fixation method gave stresses of 187.8 MPa at the plate, 45.8 MPa at the screw, and 15.4 MPa at the bone around the plate. The Type 2 (I-shaped) fixation method gave stresses of 186.6 MPa at the plate, 75.7 MPa at the screw, and 13.8 MPa at the bone around the plate. The Type 3 (inverted L-shaped) fixation method gave stresses of 28.6 MPa at the plate, 29.9 MPa at the screw, and 15.3 MPa at the bone around the plate. The Type 4 (I-shaped) fixation method gave stresses of 34.8 MPa at the plate, 36.9 MPa at the screw, and 14.9 MPa at the bone around the plate. The deflection of the plates for the four fixation methods was 0.014 mm, 0.022 mm, 0.017 mm, and 0.018 mm, respectively. CONCLUSION: The Type 3 (inverted L-shaped) fixation method offers more stability than the other fixation methods. We therefore recommend this method for the postoperative stabilization of maxillary osteotomy.
Displacement (Psychology) ; Finite Element Analysis ; Maxillary Osteotomy ; Osteotomy ; Skull

osteotomy were performed in 8 patients with Angle's II malocclusion or anterior maxillary protrusion. Cupar's method was used for operation. The period of follow up for patients were 15 months by average. This study discussed the postoperative complications and soft tissue change after anterior segmental maxillary osteotomy. There are not specific major complications.]]>
Follow-Up Studies ; Humans ; Malocclusion ; Maxillary Osteotomy ; Osteotomy ; Postoperative Complications

osteotomy, maxillary anterior segmental osteotomy, or genioplasty. First, for all of the patients, preoperative cephalometric lateral views were taken and analyzed by Quick Ceph program, and then treatment plans were decided. Visual surgery was performed as the programed plan, so the preoperative prediction was obtained through the results of the visual surgery. Second, postoperative cephalometric lateral views were taken for each of the patients to obtain the postoperative actual changes(4 months - 16 months after operation ; mean 7 months), and those were analysed by the computer program. Finally, both of the measurements were compared each other and analysed statistically. Conclusively, significant differences were found in lower lip position and pogonion(Pog) landmark. While the differences between vertical positional changes were statistically significant, the differences between horizontal positional changes were not statistically significant.]]>
Diagnosis ; Genioplasty ; Humans ; Lip ; Maxillary Osteotomy ; Orthognathic Surgery ; Osteotomy

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

osteotomy have been commonly performed for the correction of mandibular prognathism, occurred to abundant oriental people. Many authors have studied the soft tissue change after orthognathic surgery, especially between mandibular hard tissues and soft tissue of lower lip, but the study of upper lip change is comparatively little. Therefore, we studied the 12 patients, operated only sagittal split ramus osteotomy without genioplasty or maxillary osteotomy in department of oral and maxillofacial surgery, Hanyang university hospital from 1996.1. 1. to 1998. 7. 20. Preoperative and postoperative cephalometric view was measured to know the change of upper lip position and shape after mandibular setback. The result were obtained as follows. 1. The ratio of upper lip change amount to lower incisor horizontal movement was 15.1%. 2. The ratio of lower facial profile between Sn-Stm and Stm-Mes was changed from 1 : 2.352 to 1 : 2.069 after operation. 3. Post-operative upper lip was flattened 72.4% compared with pre-opreative one. 4. The vermilion zone of the upper lip increased 56% horizontally, 5.8% vertically after operation. 5. The vermilion zone ratio of the lower lip to the upper lip was change from 1 : 1.253 to 1 : 1.348. 6. The distance between esthetic line and Ls was changed from -3.958mm to -1.15mm.]]>
Genioplasty ; Humans ; Incisor ; Lip ; Maxillary Osteotomy ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Prognathism ; Surgery, Oral

osteotomy of posterolateral wall of maxillary sinus, 1. Fenestra formation on zygomatic body for easily access of reciprocationg saw to postero-lateral wall of maxillary sinus. 2. To achieve better visual field in posterolateral aspect of maxilla, fat tissue is removed from infratemporal fossa. This new, versatile procedure can be used for benign and malignant lesions of the maxillary area. We introduce cases with review of literatures.]]>
Cicatrix ; Humans ; Maxilla ; Maxillary Sinus ; Osteotomy ; Skeleton ; Visual Fields

Maxillary sinus has an anatomic limitation to bone support available for dental implant.When there is less than 10mm of bone remaining between the upper alveolar ridge crest and the maxillary sinus floor, bone augmentation should be considered. In 1994, Summers reported two sinus floor elevation techniques of immediate implant insertion,using osteotomes, for patients who have at least 5mm of bone remaining between the alveolar ridge crest and the maxillary sinus floor. One technique is osteotome sinus floor elevation (OSFE)procedure in which uses osteotomes to elevate the sinus floor. The other is bone-added OSFE (BAOSFE)procedure in which bone graft is added into osteotomy site. Both procedures conserve all of the remaining bone and selectively displace it upward,thereby raising sinus floor. This study was aimed to evaluate the long-term success rate of implants which had been placed by osteotome sinus floor elevation procedure. Between February 1996 and June 1998, 10 implants were placed using OSFE or BAOSFE procedures in 6 patients who had at least 6mm of bone remaining between the alveolar ridge crest and the sinus floor.OSFE procedures were performed in patients, 2 4mm sinus floor elevation was needed,whereas BAOSFE procedures were done in patients,more than 4mm sinus floor elevation was needed. During the mean follow-up period of 4 years 4 months (3 years 6 months~5 years 9 months), no implant was failed and all patients showed good functional results.OSFE and BAOSFE procedures seemed technically easier and less invasive compared to conventional sinus lift procedure.And both procedure have good success rate.]]>
Alveolar Process ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Osteotomy ; Transplants

Maxillary osteotomy(LeFort I, II, III) is a commonly performed maxillary surgical procedure for the correction of dentofacial deformities. Maxillary osteotomy necessitate seperation of the skeleton of the middle third of the face from its posterior attachments to the cranium. With conventional techniques, an osteotome is placed between the maxilla and pterygoid plates and tapped medially and anteriorly to separate the pterygomaxillary junction. To separate the pterygomaxillary junction safely, knowledge on the anatomical structures of the pterygopalatine fossa area is very important to surgeons. So, to clarify the anatomical structures as it relates to the surgical approach of the pterygomaxillary junction area, Korean skulls (male 110 sides, female 44 sides) were used. And 30 sides of Korean hemisectioned heads were dissected to study about the anatomical and surgical structures of the pterygopalatine fossa area. Suggestions are given regarding the prevention of the complication during the maxillary osteotomy. Results of the studies indicate that with regard to the course of the maxillary artery and the morphology of the pterygomaxillary junction, pterygomaxillary dysjunction would be safely done with pterygomaxillary osteotome of 15mm width in Koreans. And osteotomy should be angled inferiorly from the zygomaticomaxillary crest. This will minimize the risk of the damaging the pterygopalatine fossa area because the mean distance form the inferior border of the pterygomaxillary junction to the furcation of the descending palatine artery was 24.8mm.
Arteries ; Asian Continental Ancestry Group ; Dentofacial Deformities ; Female ; Head ; Humans ; Maxilla ; Maxillary Artery ; Maxillary Osteotomy ; Osteotomy ; Pterygopalatine Fossa* ; Skeleton ; Skull