下顎前歯部歯槽骨切り術を併用し上下顎移動術を行った骨格性開咬の一例

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  • A case report of skeletal openbite treated by two jaw surgery combined with mandibular anterior segmental osteotomy

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The report describes a 38 year 4 month old female patient with skeletal openbite and mandibular retrognatism. The facial profile was the Skeletal Class 2 convex type with a high angle of FMA 41.0°. These was lingual inclination at an upper incisor (U1 to FH 104.5°), labial inclination at a lower incisor (FMIA 45.0°), and the intrusion of an upper incisor and extrusion of an upper molar. The patient showed : overjet＋1.0 mm, overbite－5.0 mm, Angle Class III (Lt) and Angle Class I (Rt). The pre−surgical orthodontic treatment duration was 18 months. In order to avoid excess extrusion of the upper incisor and succeed in mandibular anterior segmental osteotomy, the space between the mandibular first premolar and second premolar on both sides was expanded to 1.5 mm for the safety of the surgical procedure. Le Fort typeⅠosteotomy was applied for the upper molar intrusion. Counterclockwise mandibular rotation was achieved by sagittal splitting ramus osteotomy. For the improvement of openbite, mandibular anterior segmental osteotomy was conducted as the first surgical treatment. Eight months after the above mentioned surgery, the improvement of mandibular retrognathism by genioplasty including plate removal of mini−plate fixation was accomplished as the second operation. At present, 18 months after the completion of active treatment, the occlusion is stable although slight relapse remains. After post−surgical orthodontic treatment, the facial profile was significantly improved, and acceptable occlusion was achieved.

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  • 松本歯学

    松本歯学 38 (2), 119-130, 2012-12-31

    松本歯科大学学会

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