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Badr H, Lee SY, Park HS, Ohe JY, Kang YG, Ahn HW. Camouflage treatment of posterior bite collapse in a patient with skeletal asymmetry by using posterior maxillary segmental osteotomy. Korean J Orthod 2020; 50:278-289. [PMID: 32632047 PMCID: PMC7369388 DOI: 10.4041/kjod.2020.50.4.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/14/2019] [Accepted: 03/29/2019] [Indexed: 11/20/2022] Open
Abstract
Orthodontic treatment of posterior bite collapse due to early loss of molars and the consequent drift of adjacent teeth is complicated. When the posterior bite collapse occurs in patients with facial asymmetry, both transverse and vertical compensation are necessary for camouflage orthodontic treatment. In such cases, posterior maxillary segmental osteotomy (PMSO) can be an effective alternative procedure that simplifies the orthodontic treatment and shows long-term stability through dental compensation within the alveolar bone housing. This case report aimed to describe the orthodontic treatment of maxillary occlusal plane canting caused by severely extruded maxillary teeth in a patient with skeletal facial asymmetry that was corrected with PMSO along with protraction of the lower second molar to replace the space of the extracted first molar. The treatment duration was 18 months, and stable results were obtained after 2 years of retention.
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Affiliation(s)
- Haitham Badr
- Department of Orthodontics, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Soo-Yeon Lee
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | | | - Joo-Young Ohe
- Department of Oral & Maxillofacial Surgery, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Yoon-Goo Kang
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
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Gavhane S, Da Costa GC, Chalakkal P, De Souza N. Segmental Osteotomy, Implants, and Restorative Procedures for the Treatment of an Extruded Maxillary Alveolar Segment. Contemp Clin Dent 2020; 10:170-173. [PMID: 32015663 PMCID: PMC6975014 DOI: 10.4103/ccd.ccd_487_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This case report highlights a case of full-mouth rehabilitation in a 38-year-old female. Extrusion of the right posterior maxillary alveolar segment had resulted due to the presence of an opposing edentulous mandibular span, which had led to complete absence of restorative space in the lower arch. Maxillary posterior segmental osteotomy was carried out to obtain adequate space for placing an implant-supported prosthesis in the opposing edentulous mandibular span. The procedures before the surgery consisted of articulation of the diagnostic casts on to a semi-adjustable Hanau™ Wide-Vue articulator and a mock surgery on the upper cast to assess the amount of segmental osteotomy necessary to accommodate an implant-supported prosthesis in the lower edentulous region. Other procedures included implant placements, root canal treatment, post and core build-up, and full-crown placement on various teeth.
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Affiliation(s)
- Sanket Gavhane
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | | | - Paul Chalakkal
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Neil De Souza
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
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Philip MR. Posterior maxillary segmental osteotomy for prosthodontic rehabilitation of vertically excess maxilla -a review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:450-455. [PMID: 30807863 DOI: 10.1016/j.jormas.2019.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/14/2019] [Accepted: 02/17/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this systematic review was to analyze the literature of the various surgical options available for the correction posterior maxillary alveolar ridge excess without going for radical approaches. It also analyzed the effectiveness of posterior maxillary segmental osteotomy in prosthetic rehabilitation in terms of stability, success rates, function, occlusion, aesthetics and long term postoperative complications. STUDY SELECTION A systematic search of Medline/Pubmed and Web of Science databases of English articles published till December 2017 for the treatment of vertical excess in the posterior maxilla for prosthetic reasons was performed. A total of 37 articles met the inclusion criteria. RESULTS Posterior maxillary segmental osteotomy (PMSO) was performed as a single stage procedure in 23 cases with minimal post- operative discomfort in all cases. The amount of superior positioning of the osteotomised maxilla ranged between 4 mm to 9 mm which provides sufficient space for prosthodontic rehabilitation. CONCLUSIONS PMSO is fairly competent in treating vertical ridge excess of posterior maxilla, makes space for prosthesis and is associated with fewer postoperative problems when a multidisciplinary team approach is put into service.
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Affiliation(s)
- M R Philip
- MOMS RCPS (Glasgow), FDSRCSEd, Faculty, Department of Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Baeg S, On S, Lee J, Song S. Posterior maxillary segmental osteotomy for management of insufficient intermaxillary vertical space and intermolar width discrepancy: a case report. Maxillofac Plast Reconstr Surg 2016; 38:28. [PMID: 27512690 PMCID: PMC4958637 DOI: 10.1186/s40902-016-0074-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS Insufficient intermaxillary space is caused by non-restoration following tooth extraction in the past, and this involves eruption of the opposing teeth and changes of the arch structure. Such cases are difficult just by a simple prosthetic approach, and diversified treatment plans should be established. Among these, posterior maxillary segmental osteotomy (PMSO) is an efficient treatment option than extraction of opposing teeth as it surgically repositions multiple erupted teeth and alveolar bone. PMSO can preserve the natural teeth; therefore, it is being regarded as a treatment method which can improve insufficient intermaxillary space significantly. CASE PRESENTATION In this case report, the first patient received PMSO in order to place an implant in the mandibular edentulous space after decreased vertical dimension is restored, and the second patient received PMSO along with orthodontic treatment to obtain the intermaxillary space and balance the interarch molar width. CONCLUSION PMSO is the treatment of choice when occlusion is compromised in the presence of decreased vertical dimension or arch length discrepancy.
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Affiliation(s)
- SeungWoo Baeg
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Wroldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do 16499 Republic of Korea
| | - SungWoon On
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Wroldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do 16499 Republic of Korea
| | - JeongKeun Lee
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Wroldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do 16499 Republic of Korea
| | - SeungIl Song
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Wroldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do 16499 Republic of Korea
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Ding WH, Li W, Chen F, Zhang JF, Lv Y, Chen XY, Lin WW, Fu Z, Shi JJ. Comparison of molar intrusion efficiency and bone density by CT in patients with different vertical facial morphology. J Oral Rehabil 2014; 42:355-62. [PMID: 25515652 DOI: 10.1111/joor.12261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2014] [Indexed: 11/29/2022]
Abstract
The purpose of this study is to examine the relationship between molar intrusion efficiency and bone density in patients with different vertical facial morphology. Thirty-six female patients, with overerupted upper first molars, were divided into two groups according to mandiblular plane angle (FH-MP): hyperdivergent, FH-MP>30° (G1), hypodivergent, FH-MP<22° (G2). Mini-screw implants with elastic chains were used to intrude upper first molars. Spiral CT was used to measure the intrusion degree of upper first molar and bone density, and molar intrusion efficiency was calculated as amount/duration (mm month(-1) ). In addition, each tooth was divided into three portions (cervical, furcation and apical) to measure the bone density. It was found in this study that treatment duration was 3·13 and 4·71 months in G1 and G2 and that the intrusion efficiency was 1·57 and 0·81 in G1 and G2 with significant difference (P < 0·05). There were significant differences in cervical, furcation and apical bone density between two groups (P < 0·05). The bone density was significantly reduced after molar intrusion. In addition, the bone density change was greater in G1 than in G2 (P < 0·05). It was concluded that molars were more easily to be intruded in hyperdivergent than in hypodivergent patients. The difference of bone density and bone density changes during intrusion may account for the variation of molar intrusion efficiency.
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Affiliation(s)
- W H Ding
- Department of Orthodontics, School of Stomatology affiliated to Medical College, Zhejiang University, Hangzhou City, China
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Papaspyridakos P, Ostuni A, Han C, Lal K. Posterior maxillary segmental osteotomy for the implant reconstruction of a vertically deficient ridge: A 3-year clinical report. J Prosthet Dent 2013; 110:69-75. [DOI: 10.1016/s0022-3913(13)00137-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hwang JH, Jung BY, Lim CS, Cha IH, Park W. Posterior maxillary segmental osteotomy concomitant with sinus lift using a piezoelectric device. J Oral Maxillofac Surg 2011; 69:2339-44. [PMID: 21802189 DOI: 10.1016/j.joms.2011.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 04/15/2011] [Accepted: 04/18/2011] [Indexed: 11/17/2022]
Abstract
Tooth loss evokes functional and esthetic problems, and adjacent teeth can move if they are not corrected in a timely manner, rendering the problems of restoring the dentition more complex. If the opposing tooth is consequently extruded, several treatment modalities may be adopted, such as occlusal adjustment, crown prosthesis, orthodontic treatment, and segmental osteotomy. Segmental osteotomy is the most aggressive and invasive treatment for restoring a problematic occlusal plane due to the complications, such as hemorrhage, loss of tooth vitality, or necrosis of the segment. Piezoelectric devices have recently been used in oral surgery and implant dentistry because they preserve the soft tissue. In this report, we describe a bilateral posterior segmental osteotomy procedure to correct a collapsed occlusal plane with sinus mucosa elevation, using piezoelectric devices to preserve the integrity of the sinus membrane and the posterior superior alveolar artery.
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Affiliation(s)
- Jae Ho Hwang
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seodaemun-Gu, Seoul, South Korea
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Basa S, Varol A, Sener ID, Sertgoz A. Posterior maxillary segmental osteotomy for restoring the mandible with dental implants: a clinical report. J Prosthet Dent 2008; 99:340-3. [PMID: 18456044 DOI: 10.1016/s0022-3913(08)60080-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Posterior segmental collapse causes narrowing of interarch space and prevents adequate restoration in the posterior quadrant. Posterior maxillary segmental osteotomy (PMSO) is an alternative option that enables prosthodontic restoration with an implant-supported fixed partial denture. The following clinical report describes prosthodontic rehabilitation with fixed prostheses after a posterior maxillary segmental osteotomy for a patient with a partially edentulous mandible.
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Affiliation(s)
- Selcuk Basa
- Department of Oral and Maxillofacial Surgery, Marmara University School of Dentistry, Istanbul, Turkey
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