Surgical correction of vertical maxillary excess associated with mandibular self-rotation

Abstract

Introduction: The Class I skeletal deformity associated with vertical maxillary excess is a rare condition reported in the literature. Surgical impaction allows the correction of the long face and gummy smile. Objective: This case report aimed to evaluate the positioning of the condyle after Le Fort I osteotomy associated with mandibular selfrotation. Case report: The patient underwent orthognathic surgery for the correction of maxillary vertical excess. Tomography studies were performed to evaluate the initial and final position of the condyle. The patient improved mastication, breathing and phonetics, with esthetic benefit. Conclusion: After the Le Fort I osteotomy and mandibular self-rotation, the condyle remained stable occupying a new anterior-superior position in the glenoid fossa and patient's TMJ remained asymptomatic after 9 months of postoperative follow-up.

Orthosurgical management of skeletal class-II malocclusion with vertical growth pattern- A case report

“…Clinically, VME is categorized according to the presence or absence of anterior open bite. 10 In this case the treatment protocol adopted is the nonextraction treatment modality with surgical mandibular advancement for the correction of underlying mandibular hypoplasia. In the above case maxilla was normal both in sagittal as well as in the transverse plane, but the mandible was deficient in the sagittal plane with increased vertical vector.…”

Gummy Smile: A Review of Etiology, Manifestations, and Treatment

“…The lower third of the face is long, leading to a retrognathic shape of the jaw. 17 Furthermore, the incisal edge of the upper anterior teeth might be covered by the lower lip because of the extravagant downward growth of the maxilla. 16 Peck et al, 9 and Mackley 18 found that a Gummy Smile is highly related to anterior vertical maxillary excess (about 2-3 mm).…”

“…35 The Le Fort I osteotomy of the maxilla allows reduction of bone between the nasal floor and apices of maxillary teeth which permits superior repositioning (impaction) of the maxilla. 17 When having bimaxillary protrusion, the treatment option may be composed of first premolar extractions followed by the osteotomy through the extraction sites to mobilize the anterior segment of the maxilla. The aim is to setback the segment in addition to lessening the labial flaring of the incisors.…”

The Management of Vertical Maxillary Excess with Orthodontic Mini Screws to Achieve a Pleasant Smile: A Two Year Follow Up Case Report

“…This is known as a gummy smile, and about 10% of the population between 20 and 30 years of age present excessive gingival display, which is more prevalent in women [1][2]. 7% of the 10% gingival exposure self-reduces by forceful closure of the upper and lower lip by reducing incisor display [3].…”