Severe unilateral scissor bite and bimaxillary protrusion treated by horseshoe Le Fort I osteotomy combined with mid-alveolar osteotomy

Abstract

This report describes an orthognathic surgical case employing horseshoe Le Fort I osteotomy (HLFO) combined with mid-alveolar osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) for a patient with severe unilateral scissor bite and bimaxillary protrusion. A female patient (aged 26 years, 2 months) presented with a chief complaint of dysmasesis caused by scissor bite on the right side. The clinical examination revealed difficulty in lip closure and a convex profile. Overerupted right maxillary premolars and molars and lingual tipping of the right mandibular premolars and molars were indicated before treatment. After 3 months of presurgical orthodontic treatment, two-jaw surgery involving a combination of HLFO with mid-alveolar osteotomy and BSSRO was performed. A good interdigitation in the right side was established by superiorposterior-medial movement of the dento-alveolar segment of the maxilla. Next, both the maxilla and mandible were moved superiorly and posteriorly to correct the improper lip protrusion, thereby improving the patient's profile. Our results suggest that this new orthognathic surgery techniqueachieved by combining HLFO with mid-alveolar osteotomy and BSSRO-is effective for adult patients exhibiting severe unilateral scissor bite and bimaxillary protrusion. (Angle Orthod.

Severe unilateral scissors-bite with a constricted mandibular arch: Bite turbos and extra-alveolar bone screws in the infrazygomatic crests and mandibular buccal shelf

“…Therefore, most severe scissors-bite cases have been managed with surgical orthodontics. 6,27,28 The current patient (Figs. 1-4) presented with a scissors-bite of the UR buccal segment that articulated with a lingually tipped LR buccal segment.…”

<p><strong> Perbedaan hasil analisis sefalometri McNamara sebelum dan sesudah perawatan maloklusi kelas I protrusif bimaksiler </p></strong><em/><p><strong> Differences in the result of MCNamara cephalometric analysis before and after protrusive bimaxillary class I malocclusion treatment</p></strong>

“…Perawatan protrusif bimaksiler dapat berupa tindakan ortodonti, bedah ortognatik atau kombinasi. 7,8 Rencana perawatan yang sering dilakukan untuk maloklusi ini adalah pencabutan empat gigi premolar pertama, lalu dilakukan retraksi serta retroklinasi gigi anterior rahang atas dan bawah. 7,8 Tindakan bedah ortognati dapat berupa subapical osteotomies, horseshoe Le Fort I osteotomy (HLFO), bilateral sagittal split ramus osteotomy (BSSRO).…”

Introducing surface-to-surface matching technique to evaluate mandibular symmetry: A retrospective study

“…And unilateral scissor bite was reported to be associated with disordered chewing patterns and occlusal interference. The decayed tooth, tooth elongation, and bad periodontal condition can be observed in the scissor bite side [ 14 ]. In addition, the scissor bite can cause a long-term blockage of the bite, which hinders the growth of the mandible.…”