英语论文网

ular 29
4 19 W M MR,AOB Cleft lip and
Palate Anterior, 9 1,2,3,4 Unlateral widening of
nasal alar base 29
5 44 W M MR Posttraumatic Anterior, 10 1,5 32
6 32 B F MR Posttraumatic Anterior, 9 1,2 16
7 20 W F MAH Developmental Posterior,4 1
Superior, 6 Flatterning of
upper lip 5
8 16 W M MR Cleft lip and
Palate Anterior, 12
Lateral 6 1 Relapse 15
9 19 B F BP,MAH,AOB Developmental Superior, 10 1, 6 6
10 18 W M MR Cleft lip and
palate Anterior, 13 1,2 8
11 26 W F MAH Developmental Posterior, 15
Superior, 7 1 13
12 25 W F MAN,AOB Developmental Posterior, 4 1,3,4 13
13 23 W F AOB Idiopathic Superior, 10 1,3,7 Widening of
nasal alar bases;
buckling of 5
nasal septum
14 20 W M MR Posttraumatic Anterior, 4 1,3,5,7
14 17 W F MAH, AOB Developmental Superior, 6 1,3,4

*KEY, AOB= Anterior open bite Key: l. Total maxillary osteotomy
MAH = Maxillary alveolar hyperplasia 2. Bone graft
BP = Bimaxillary protrusion 3. Genioplasty
MR = Maxillary retrusion 4. Orthodontics
MP = Mandibular prognathism 5. Contour augmentation of malat eminence
and infraorbital rim
6. Mandibular osteotomy
7. Rhinoplasty
■ Anatomical Considerations
When anterior and posterior maxillary dento-alveolar segments are repositioned simultaneously; special attention must be given to the anatomy of the palatal vault and the relative length of the palatal roots. The high palatal vault associated with maxillary alveolar hyperplasia and skeletal type anterior open bite facilitates sectioning of the lateral portion of the maxilla through the maxillary sinus into the oral cavity (Pig 4C). The anterior portion of the maxilla is mobilized after the lateral and vertical bone incisions are connected by transverse palatal ostectomy or osteotomy.
The posterior maxillary dento-alveolar segments can then be moved anteriorly, posteriorly, laterally, or impacted into the maxillary sinuses. The entire dento-alveolar portion of the maxilla can also be repositioned without extraction of Teeth.
When, however, the palatal vault is shallow and the space between the palatal roots and the horizontal portion of the palate is small, sagittal bone incisions are made directly into the nasal cavity (Fig 4D). Superior movement of the posterior maxillary dental alveolar segments is made at the expense of the nasal cavity. In cases where expansion of the lateral maxilla is indicated, dual access to the buccal and palatal areas may indeed be necessary because of the inelastic palatal mucosa. Sagittal or parasagittal relief incisions through the palatal mucoperiosteum will facilitate lateral movement of the maxilla. The margins of such naps are raised minimally to maximize the palatal bone-soft tissue pedicle.
The excellent accessibility and visibility afforded by the Le Forte I "downfracturing" technique for simultaneous anterior and posterior maxillary osteotomies must be weighed against the disadvantages. Buckling and displacement of the nasal septum are possible because the horizontal portion of the hard palate. Pedicled to palatal mucosa is movable and separated from the nasal septum. These problems can be obviated when the surgery is executed from