Abstract
This paper presents the case of a 31-year-old female with severe maxillary protrusion who received surgical orthognathic treatment by distraction osteogenesis. Severe transverse maxillo-mandibular discrepancy with significant crowding, and labial tipping of the maxillary incisors further compounded this problem. A two-stage surgical procedure was performed. The first-stage operation involved Le Fort I osteotomy and median palate osteotomy in the maxilla and median osteotomy in the mandible. The maxilla was widened by 9mm, the mandible by 6mm. Bilateral maxillary first pre-molars were extracted before pre-operative orthodontic treatment. The second-stage procedure comprised anterior maxillary alveolar segmental osteotomy and Le Fort I osteotomy, sagittal splitting ramus osteotomy, anterior mandibular segmental osteotomy and genioplasty. Facial profile was significantly improved. Overjet changed from 15mm to 4mm, and occlusal stability was established. Maxillo-mandibular widening by distraction osteogenesis proved to be both aesthetically and functionally successful, with minimum extraction of teeth.
