Abstract
Objective: To present a case of vertical maxillary excess managed through a modified Le Fort I osteotomy combined with anterior maxillary segmental osteotomy, demonstrating its effectiveness in addressing malocclusion, a gummy smile, and lip incompetence.
Case Report: A 27-year-old female presented with habitual mouth breathing due to lip incompetence, maxillary prognathism, a gummy smile, and a convex profile with a shallow labiomental fold. Despite previous extractions of teeth 36 and 46, an Angle’s Class II canine relationship was noted bilaterally, with an overjet of 5 mm and an overbite of 3 mm. Following initial orthodontic preparation, a Le Fort I osteotomy was performed, combined with anterior maxillary segmental osteotomy using the extraction sockets of teeth 14 and 24 to separate the anterior and posterior segments. The maxillary segments were repositioned using a palatal splint and surgical wafer and secured with L plates and screws. Genioplasty was also conducted to enhance facial aesthetics and correct lip incompetence. The patient was hospitalized for two days and received standard postoperative care, including analgesics, steroids, and antibiotics, while following a soft diet regimen.
Results: The combined surgical approach resulted in a well-aligned occlusal plane, improved incisor inclination, and correction of the gummy smile. The addition of genioplasty significantly enhanced the patient’s facial profile and lip competence. Follow-up examinations confirmed good occlusion, stable results, and no complications.
Conclusion: This case demonstrates the efficacy of combining a segmental Le Fort I osteotomy with anterior maxillary segmental osteotomy for correcting maxillary excess and enhancing facial aesthetics. The precise segmentation of the maxilla and inclusion of genioplasty provided targeted corrections, underscoring the importance of personalized surgical planning in complex craniofacial cases.
Recommended Citation
Ananda, Nissia; Lu, Ming-Yi; Ariawan, Dwi; Julia, Vera; and Peng, Chih-Yu
(2024)
"Two-segment le fort I osteotomy in orthognathic surgery utilizing anterior maxillary segmental osteotomy: A case report,"
Journal of Dentomaxillofacial Science: Vol. 9:
Iss.
3, Article 6.
DOI: https://doi.org/10.15562/jdmfs.v9i3.1871
Available at:
https://scholarhub.unhas.ac.id/jdmfs/vol9/iss3/6
Pages
225-228
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Rights
©2025Nissia Ananda, Ming-Yi Lu, Dwi Ariawan, Vera Julia, Ching-Yu Peng
DOI
10.15562/jdmfs.v9i3.1871