Segmental maxillary osteotomies and subapical mandibular osteotomies

Abstract

Orthognathic surgery is considered to be the principal tool for correcting dentofacial deformity. The goal of this procedure is to achieve functional occlusion and favorable profile. Segmental maxillary osteotomies and subapical mandibular osteotomies are commonly indicated in correction for dentofacial deformities in which only a portion of the dentoalveolar arch requires repositioning for functional and esthetic reasons. These procedures are divided into four types: anterior or posterior segmental maxillary osteotomies and anterior or posterior subapical mandibular osteotomies. Although the use of these osteotomies has been decreasing due to improvements in orthodontic treatment techniques and other surgical techniques, these procedures are useful for patients with dentoalveolar deformities and are also frequently used in combination with other jaw surgeries. For clinical success in these osteotomies, it is necessary to achieve good mobilization of the segments to allow for passive repositioning in the predetermined position and to maintain optimal vascularity to mobilized segments and avoid damages to teeth, periodontal tissue and nerve tissue.