The Surgical Management of Post-Traumatic Malocclusion

Secondary Correction of Post-traumatic Craniofacial Deformities

“…Planning with dental models and use of occlusal splint to guide the intraoperative occlusion is sometimes required. 11 Maxillary displacement due to LeFort I to III fractures is posterior-inferior due to pull of the medial pterygoid muscles with anterior cephalad telescoping causing midface retrusion, decreased midface height, and anterior open bite due to posterior premature occlusion with the mandibular molars. Regardless of the original fracture pattern, a high LeFort I type osteotomy is the simplest way to restore the occlusion.…”

Secondary Reconstruction of Post-traumatic Maxillomandibular Deformities

“…9 Similar to the management of a malpositioned zygoma in which osteotomies are performed along fracture lines, a similar approach is taken for maxillomandibular malunion. In the maxillomandibular region, malunion can result in facial asymmetry, malocclusion, or both.…”

“…Usually, in less severe cases a patient can be guided into an acceptable maxillomandibular relationship with the use of nonoperative techniques such as occlusal equilibration or guiding elastics. 9 Even though closure of open-bite malocclusions can be achieved with a maxillary (Le Fort 1) procedure or a mandibular procedure, in the authors' experience, combined maxillary-mandibular osteotomies will often provide the most stable long-term result (Fig. The principles of orthognathic surgery with supportive orthodontic treatment are used to reproduce the initial fracture and reposition the mandible, maxilla, or both.…”

“…9 Multisegmental osteotomies with interpositional bone grafts are usually needed to correct the malocclusion. 9 Multisegmental osteotomies with interpositional bone grafts are usually needed to correct the malocclusion.…”

“…This can be quite helpful since presurgical orthodontics can in certain cases negate the need for multisegment maxillary surgery 9 and allow a conventional Le Fort I osteotomy to be performed ( Fig. Therefore, proper assessment of the severity of a post-traumatic patient's maxillomandibular deformity is critical, for this will determine the treatment options that will best address the patient's deformities.…”