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Erschienen in: Oral and Maxillofacial Surgery 4/2012

01.12.2012 | Original Article

Closure of anterior open bites with mandibular surgery: advantages and disadvantages of this approach

verfasst von: Joseph E. Van Sickels, Aaron Wallender

Erschienen in: Oral and Maxillofacial Surgery | Ausgabe 4/2012

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Abstract

Introduction

While closure of an anterior open bite with a mandibular procedure may predispose a surgical case to instability, there are instances where this type of treatment planning is indicated.

Methods and materials

In this paper, the authors review the advantages and disadvantages of this approach and present three cases with varying degrees of success. Additionally, treatment strategies are presented for managing large advancements of the maxilla and mandible.

Results and summary

Counterclockwise rotation of the mandible is a valuable tool that can be used in the treatment of patients with dentofacial deformities.
Literatur
1.
Zurück zum Zitat LaBanc JP, Turvey T, Epker BN (1982) Results following simultaneous mobilization of the maxilla and mandible for the correction of dentofacial deformities: analysis of 100 consecutive patients. Oral Surg Oral Med Oral Pathol 54:607–12PubMedCrossRef LaBanc JP, Turvey T, Epker BN (1982) Results following simultaneous mobilization of the maxilla and mandible for the correction of dentofacial deformities: analysis of 100 consecutive patients. Oral Surg Oral Med Oral Pathol 54:607–12PubMedCrossRef
2.
Zurück zum Zitat Turvey T, Hall DJ, Fish LC, Epker BN (1982) Surgical-orthodontic treatment planning for simultaneous mobilization of the maxilla and mandible in the correction of dentofacial deformities. Oral Surg Oral Med Oral Pathol 54:491–8PubMedCrossRef Turvey T, Hall DJ, Fish LC, Epker BN (1982) Surgical-orthodontic treatment planning for simultaneous mobilization of the maxilla and mandible in the correction of dentofacial deformities. Oral Surg Oral Med Oral Pathol 54:491–8PubMedCrossRef
3.
Zurück zum Zitat Proffit WR, Turvey TA, Phillips C (1996) Orthognathic surgery: a hierarchy of stability. Int J Adult Orthodon Orthognath Surg 11:191–204PubMed Proffit WR, Turvey TA, Phillips C (1996) Orthognathic surgery: a hierarchy of stability. Int J Adult Orthodon Orthognath Surg 11:191–204PubMed
4.
Zurück zum Zitat Proffit WR, Turvey TA, Phillips C (2007) The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension. Head Face Med 3:21PubMedCrossRef Proffit WR, Turvey TA, Phillips C (2007) The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension. Head Face Med 3:21PubMedCrossRef
5.
Zurück zum Zitat Proffit WR, Bailey LJ, Phillips C, Turvey TA (2000) Long-term stability of surgical open-bite correction by Le Fort I osteotomy. Angle Orthod 70:112–7PubMed Proffit WR, Bailey LJ, Phillips C, Turvey TA (2000) Long-term stability of surgical open-bite correction by Le Fort I osteotomy. Angle Orthod 70:112–7PubMed
6.
Zurück zum Zitat Teittinen M, Tuovinen V, Tammela L, Schatzle, Peltomaki T (2012) Long-term stability of anterior open bite closure corrected by surgical orthodontic treatment. Eur J Orthod 34:238–43PubMedCrossRef Teittinen M, Tuovinen V, Tammela L, Schatzle, Peltomaki T (2012) Long-term stability of anterior open bite closure corrected by surgical orthodontic treatment. Eur J Orthod 34:238–43PubMedCrossRef
7.
Zurück zum Zitat Espeland L, Dowling PA, Mobarak KA, Stenvik A (2008) Three-year stability of open-bite correction by 1-piece maxillary osteotomy. Am J Orthod Dentofac Orthop 134:60–6CrossRef Espeland L, Dowling PA, Mobarak KA, Stenvik A (2008) Three-year stability of open-bite correction by 1-piece maxillary osteotomy. Am J Orthod Dentofac Orthop 134:60–6CrossRef
8.
Zurück zum Zitat Maia FA, Janson G, Barros SE, Maia NG, Chiqueto K, Nakamura AY (2010) Long-term stability of surgical-orthodontic open-bite correction. Am J Orthod Dentofac Orthop 138:254.e1–254.e10CrossRef Maia FA, Janson G, Barros SE, Maia NG, Chiqueto K, Nakamura AY (2010) Long-term stability of surgical-orthodontic open-bite correction. Am J Orthod Dentofac Orthop 138:254.e1–254.e10CrossRef
9.
Zurück zum Zitat Jensen U, Ruf S (2010) Success rate of anterior open-bite orthodontic orthognathic surgical treatment. Am J Orthod Dentofac Orthop 138:716–9CrossRef Jensen U, Ruf S (2010) Success rate of anterior open-bite orthodontic orthognathic surgical treatment. Am J Orthod Dentofac Orthop 138:716–9CrossRef
10.
Zurück zum Zitat Van Sickels JE, Dolce C, Keeling S, Tiner BD, Clark GM, Rugh JD (2000) Technical factors accounting for stability of a bilateral sagittal split osteotomy advancement: wire osteosynthesis versus rigid fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:19–23PubMedCrossRef Van Sickels JE, Dolce C, Keeling S, Tiner BD, Clark GM, Rugh JD (2000) Technical factors accounting for stability of a bilateral sagittal split osteotomy advancement: wire osteosynthesis versus rigid fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:19–23PubMedCrossRef
11.
Zurück zum Zitat Reitzik M, Barer PG, Wainwright WM, Lim B (1990) The surgical treatment of skeletal anterior open-bite deformities with rigid internal fixation in the mandible. Am J Orthod Dentofac Orthop 97:52–7CrossRef Reitzik M, Barer PG, Wainwright WM, Lim B (1990) The surgical treatment of skeletal anterior open-bite deformities with rigid internal fixation in the mandible. Am J Orthod Dentofac Orthop 97:52–7CrossRef
12.
Zurück zum Zitat McCollum AG, Reyneke JP, Wolford LM (1989) An alternative for the correction of the class II low mandibular plane angle. Oral Surg Oral Med Oral Pathol 67:231–41PubMedCrossRef McCollum AG, Reyneke JP, Wolford LM (1989) An alternative for the correction of the class II low mandibular plane angle. Oral Surg Oral Med Oral Pathol 67:231–41PubMedCrossRef
13.
Zurück zum Zitat Chemello PD, Wolford LM, Buschang PH (1994) Occlusal plane alteration in orthognathic surgery—Part II: long-term stability of results. Am J Orthod Dentofac Orthop 106:434–40CrossRef Chemello PD, Wolford LM, Buschang PH (1994) Occlusal plane alteration in orthognathic surgery—Part II: long-term stability of results. Am J Orthod Dentofac Orthop 106:434–40CrossRef
14.
Zurück zum Zitat Wolford LM, Chemello PD, Hilliard F (1994) Occlusal plane alteration in orthognathic surgery—Part I: effects on function and esthetics. Am J Orthod Dentofac Orthop 106:304–16CrossRef Wolford LM, Chemello PD, Hilliard F (1994) Occlusal plane alteration in orthognathic surgery—Part I: effects on function and esthetics. Am J Orthod Dentofac Orthop 106:304–16CrossRef
15.
Zurück zum Zitat Frey DR, Hatch JP, Van Sickels JE, Dolce C, Rugh JD (2007) Alteration of the mandibular plane during sagittal split advancement: short- and long-term stability. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:160–9PubMedCrossRef Frey DR, Hatch JP, Van Sickels JE, Dolce C, Rugh JD (2007) Alteration of the mandibular plane during sagittal split advancement: short- and long-term stability. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:160–9PubMedCrossRef
16.
Zurück zum Zitat Bisase B, Johnson P, Stacey M (2010) Closure of the anterior open bite using mandibular sagittal split osteotomy. Brit J Oral Maxillofac Surg 48:352–355CrossRef Bisase B, Johnson P, Stacey M (2010) Closure of the anterior open bite using mandibular sagittal split osteotomy. Brit J Oral Maxillofac Surg 48:352–355CrossRef
17.
Zurück zum Zitat Reyneke JP, Bryant RS, Suuronen R, Becker PJ (2007) Postoperative skeletal stability following clockwise and counter-clockwise rotation of the maxillomandibular complex compared to conventional orthognathic treatment. Brit J Oral Maxillofac Surg 45:56–64CrossRef Reyneke JP, Bryant RS, Suuronen R, Becker PJ (2007) Postoperative skeletal stability following clockwise and counter-clockwise rotation of the maxillomandibular complex compared to conventional orthognathic treatment. Brit J Oral Maxillofac Surg 45:56–64CrossRef
18.
Zurück zum Zitat Prinsell JR (2002) Maxillomandibular advancement surgery for obstructive sleep apnea syndrome. J Am Dent Assoc 133:1489–97PubMed Prinsell JR (2002) Maxillomandibular advancement surgery for obstructive sleep apnea syndrome. J Am Dent Assoc 133:1489–97PubMed
19.
Zurück zum Zitat Ronchi P, Novelli G, Colombo L, Valsecchi S, Oldani A, Zucconi M, Paddeu A (2010) Effectiveness of maxillo-mandibular advancement in obstructive sleep apnea patients with and without skeletal anomalies. Int J Oral Maxillofac Surg 39:541–7PubMedCrossRef Ronchi P, Novelli G, Colombo L, Valsecchi S, Oldani A, Zucconi M, Paddeu A (2010) Effectiveness of maxillo-mandibular advancement in obstructive sleep apnea patients with and without skeletal anomalies. Int J Oral Maxillofac Surg 39:541–7PubMedCrossRef
20.
Zurück zum Zitat Abramson Z, Susarla SM, Lawler M, Bouchard C, Troulis M, Kaban LB (2011) Three-dimensional computed tomographic airway analysis of patients with obstructive sleep apnea treated by maxillomandibular advancement. J Oral Maxillofac Surg 69:677–86PubMedCrossRef Abramson Z, Susarla SM, Lawler M, Bouchard C, Troulis M, Kaban LB (2011) Three-dimensional computed tomographic airway analysis of patients with obstructive sleep apnea treated by maxillomandibular advancement. J Oral Maxillofac Surg 69:677–86PubMedCrossRef
21.
Zurück zum Zitat Fairburn SC, Waite PD, Vilos G, Harding SM, Bernreuter W, Cure J, Cherala S (2007) Three-dimensional changes in upper airways of patients with obstructive sleep apnea following maxillomandibular advancement. J Oral Maxillofac Surg 65:6–12PubMedCrossRef Fairburn SC, Waite PD, Vilos G, Harding SM, Bernreuter W, Cure J, Cherala S (2007) Three-dimensional changes in upper airways of patients with obstructive sleep apnea following maxillomandibular advancement. J Oral Maxillofac Surg 65:6–12PubMedCrossRef
22.
Zurück zum Zitat Prinsell JR (2012) Primary and secondary telegnathic maxillomandibular advancement, with or without adjunctive procedures, for obstructive sleep apnea in adults: a literature review and treatment recommendations. J Oral Maxillofac Surg 70:1659–77PubMedCrossRef Prinsell JR (2012) Primary and secondary telegnathic maxillomandibular advancement, with or without adjunctive procedures, for obstructive sleep apnea in adults: a literature review and treatment recommendations. J Oral Maxillofac Surg 70:1659–77PubMedCrossRef
23.
Zurück zum Zitat Carpagnano GE (2011) Exhaled breath analysis and sleep. J Clin Sleep Med 7(5 Suppl):S34–7PubMed Carpagnano GE (2011) Exhaled breath analysis and sleep. J Clin Sleep Med 7(5 Suppl):S34–7PubMed
24.
Zurück zum Zitat Borstlap WA, Stoelinga PJ, Hoppenreijs TJ, van’t Hof MA (2004) Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part II. Radiographic parameters. Int J Oral Maxillofac Surg 33:535–42PubMedCrossRef Borstlap WA, Stoelinga PJ, Hoppenreijs TJ, van’t Hof MA (2004) Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part II. Radiographic parameters. Int J Oral Maxillofac Surg 33:535–42PubMedCrossRef
25.
Zurück zum Zitat Borstlap WA, Stoelinga PJ, Hoppenreijs TJ, van't Hof MA. (2004) Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part III—condylar remodeling and resorption. 33:649-55 Borstlap WA, Stoelinga PJ, Hoppenreijs TJ, van't Hof MA. (2004) Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part III—condylar remodeling and resorption. 33:649-55
26.
Zurück zum Zitat Scheerlinck JP, Stoelinga PJ, Blijdorp PA, Brouns JJ, Nijs ML (1994) Sagittal split advancement osteotomies stabilized with miniplates. A 2-5-year follow-up. Int J Oral Maxillofac Surg 23:127–31PubMedCrossRef Scheerlinck JP, Stoelinga PJ, Blijdorp PA, Brouns JJ, Nijs ML (1994) Sagittal split advancement osteotomies stabilized with miniplates. A 2-5-year follow-up. Int J Oral Maxillofac Surg 23:127–31PubMedCrossRef
27.
Zurück zum Zitat Cutbirth M, Van Sickels JE, Thrash WJ (1998) Condylar resorption after bicortical screw fixation of mandibular advancement. J Oral Maxillofac Surg 56:178–82PubMedCrossRef Cutbirth M, Van Sickels JE, Thrash WJ (1998) Condylar resorption after bicortical screw fixation of mandibular advancement. J Oral Maxillofac Surg 56:178–82PubMedCrossRef
28.
Zurück zum Zitat Mobarak KA, Espeland L, Krogstad O, Lyberg T (2001) Mandibular advancement surgery in high-angle and low-angle class II patients: different long-term skeletal responses. Am J Orthod Dentofac Orthop 119:368–81CrossRef Mobarak KA, Espeland L, Krogstad O, Lyberg T (2001) Mandibular advancement surgery in high-angle and low-angle class II patients: different long-term skeletal responses. Am J Orthod Dentofac Orthop 119:368–81CrossRef
29.
Zurück zum Zitat Araujo A, Schendel SA, Wolford LM, Epker BN (1978) Total maxillary advancement with and without bone grafting. J Oral Surg 36:849–58PubMed Araujo A, Schendel SA, Wolford LM, Epker BN (1978) Total maxillary advancement with and without bone grafting. J Oral Surg 36:849–58PubMed
30.
Zurück zum Zitat Lye KW, Deatherage JR, Waite PD (2008) The use of demineralized bone matrix for grafting during Le Fort I and chin osteotomies: techniques and complications. J Oral Maxillofac Surg 66:1580–5PubMedCrossRef Lye KW, Deatherage JR, Waite PD (2008) The use of demineralized bone matrix for grafting during Le Fort I and chin osteotomies: techniques and complications. J Oral Maxillofac Surg 66:1580–5PubMedCrossRef
31.
Zurück zum Zitat Mehra P, Castro V, Freitas RZ, Wolford LM (2002) Stability of the Le Fort I osteotomy for maxillary advancement using rigid fixation and porous block hydroxyapatite grafting. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:18–23PubMedCrossRef Mehra P, Castro V, Freitas RZ, Wolford LM (2002) Stability of the Le Fort I osteotomy for maxillary advancement using rigid fixation and porous block hydroxyapatite grafting. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:18–23PubMedCrossRef
32.
Zurück zum Zitat Waite PD, Tejera TJ, Anucul B (1996) The stability of maxillary advancement using Le Fort I osteotomy with and without genial bone grafting. Int J Oral Maxillofac Surg 25:264–267PubMedCrossRef Waite PD, Tejera TJ, Anucul B (1996) The stability of maxillary advancement using Le Fort I osteotomy with and without genial bone grafting. Int J Oral Maxillofac Surg 25:264–267PubMedCrossRef
33.
Zurück zum Zitat Tuovinen V, Suuronen R, Teittinen M, Nurmenniemi P (2010) Comparison of the stability of bioabsorbable and titanium osteosynthesis materials for rigid internal fixation in orthognathic surgery. A prospective randomized controlled study in 101 patients with 192 osteotomies. Int J Oral Maxillofac Surg 39:1059–65PubMedCrossRef Tuovinen V, Suuronen R, Teittinen M, Nurmenniemi P (2010) Comparison of the stability of bioabsorbable and titanium osteosynthesis materials for rigid internal fixation in orthognathic surgery. A prospective randomized controlled study in 101 patients with 192 osteotomies. Int J Oral Maxillofac Surg 39:1059–65PubMedCrossRef
34.
Zurück zum Zitat Lye KW, Waite PD, Wang D, Sittitavornwong S (2008) Predictability of prebent advancement plates for use in maxillomandibular advancement surgery. J Oral Maxillofac Surg 66:1625–9PubMedCrossRef Lye KW, Waite PD, Wang D, Sittitavornwong S (2008) Predictability of prebent advancement plates for use in maxillomandibular advancement surgery. J Oral Maxillofac Surg 66:1625–9PubMedCrossRef
35.
Zurück zum Zitat Araujo MM, Waite PD, Lemons JE (2001) Strength analysis of Le Fort I osteotomy fixation: titanium versus resorbable plates. J Oral Maxillofac Surg 59:1034–9PubMedCrossRef Araujo MM, Waite PD, Lemons JE (2001) Strength analysis of Le Fort I osteotomy fixation: titanium versus resorbable plates. J Oral Maxillofac Surg 59:1034–9PubMedCrossRef
36.
Zurück zum Zitat Bohluli B, Motamedi MH, Bohluli P, Sarkarat F, Moharamnejad N, Tabrizi MH (2010) Biomechanical stress distribution on fixation screws used in bilateral sagittal split ramus osteotomy: assessment of 9 methods via finite element method. J Oral Maxillofac Surg 68:2765–9PubMedCrossRef Bohluli B, Motamedi MH, Bohluli P, Sarkarat F, Moharamnejad N, Tabrizi MH (2010) Biomechanical stress distribution on fixation screws used in bilateral sagittal split ramus osteotomy: assessment of 9 methods via finite element method. J Oral Maxillofac Surg 68:2765–9PubMedCrossRef
37.
Zurück zum Zitat Peterson GP, Haug RH, Van Sickels J (2005) A biomechanical evaluation of bilateral sagittal ramus osteotomy fixation techniques. J Oral Maxillofac Surg 63:1317–24PubMedCrossRef Peterson GP, Haug RH, Van Sickels J (2005) A biomechanical evaluation of bilateral sagittal ramus osteotomy fixation techniques. J Oral Maxillofac Surg 63:1317–24PubMedCrossRef
38.
Zurück zum Zitat Joss CU, Vassalli IM (2009) Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review. J Oral Maxillofac Surg 67:301–13PubMedCrossRef Joss CU, Vassalli IM (2009) Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review. J Oral Maxillofac Surg 67:301–13PubMedCrossRef
39.
Zurück zum Zitat Gassmann CJ, Van Sickels JE, Thrash WJ (1990) Causes, location, and timing of relapse following rigid fixation after mandibular advancement. J Oral Maxillofac Surg 48:450–4PubMedCrossRef Gassmann CJ, Van Sickels JE, Thrash WJ (1990) Causes, location, and timing of relapse following rigid fixation after mandibular advancement. J Oral Maxillofac Surg 48:450–4PubMedCrossRef
40.
Zurück zum Zitat Van Sickels JE, Richardson DA (1996) Stability of orthognathic surgery: a review of rigid fixation. Br J Oral Maxillofac Surg 34:279–85PubMedCrossRef Van Sickels JE, Richardson DA (1996) Stability of orthognathic surgery: a review of rigid fixation. Br J Oral Maxillofac Surg 34:279–85PubMedCrossRef
41.
Zurück zum Zitat Van Sickels JE (1991) A comparative study of bicortical screws and suspension wires versus bicortical screws in large mandibular advancements. J Oral Maxillofac Surg 49:1293–8PubMedCrossRef Van Sickels JE (1991) A comparative study of bicortical screws and suspension wires versus bicortical screws in large mandibular advancements. J Oral Maxillofac Surg 49:1293–8PubMedCrossRef
42.
Zurück zum Zitat Brasileiro BF, Grempel RG, Ambrosano GM, Passeri LA (2009) An in vitro evaluation of rigid internal fixation techniques for sagittal split ramus osteotomies: advancement surgery. J Oral Maxillofac Surg 67:809–17PubMedCrossRef Brasileiro BF, Grempel RG, Ambrosano GM, Passeri LA (2009) An in vitro evaluation of rigid internal fixation techniques for sagittal split ramus osteotomies: advancement surgery. J Oral Maxillofac Surg 67:809–17PubMedCrossRef
43.
Zurück zum Zitat Solano-Hernández B, Antonarakis GS, Scolozzi P, Kiliaridis S. (2012 Jun 11) Combined orthodontic and orthognathic surgical treatment for the correction of skeletal anterior open-bite malocclusion: a systematic review on vertical stability. J Oral Maxillofac Surg. (in press) Solano-Hernández B, Antonarakis GS, Scolozzi P, Kiliaridis S. (2012 Jun 11) Combined orthodontic and orthognathic surgical treatment for the correction of skeletal anterior open-bite malocclusion: a systematic review on vertical stability. J Oral Maxillofac Surg. (in press)
44.
Zurück zum Zitat Smithpeter J, Covell D Jr (2010) Relapse of anterior open bites treated with orthodontic appliances with and without orofacial myofunctional therapy. Am J Orthod Dentofac Orthop 137:605–14CrossRef Smithpeter J, Covell D Jr (2010) Relapse of anterior open bites treated with orthodontic appliances with and without orofacial myofunctional therapy. Am J Orthod Dentofac Orthop 137:605–14CrossRef
45.
Zurück zum Zitat Wriedt S, Buhl V, Al-Nawas B, Wehrbein H (2009) Combined treatment of open bite—long-term evaluation and relapse factors. J Orofac Orthop 70:318–26PubMedCrossRef Wriedt S, Buhl V, Al-Nawas B, Wehrbein H (2009) Combined treatment of open bite—long-term evaluation and relapse factors. J Orofac Orthop 70:318–26PubMedCrossRef
46.
Zurück zum Zitat Hoppenreijs TJ, Freihofer HP, Stoelinga PJ, Tuinzing DB, van’t Hof MA (1998) Condylar remodelling and resorption after Le Fort I and bimaxillary osteotomies in patients with anterior open bite. A clinical and radiological study. Int J Oral Maxillofac Surg 27:81–91PubMedCrossRef Hoppenreijs TJ, Freihofer HP, Stoelinga PJ, Tuinzing DB, van’t Hof MA (1998) Condylar remodelling and resorption after Le Fort I and bimaxillary osteotomies in patients with anterior open bite. A clinical and radiological study. Int J Oral Maxillofac Surg 27:81–91PubMedCrossRef
Metadaten
Titel
Closure of anterior open bites with mandibular surgery: advantages and disadvantages of this approach
verfasst von
Joseph E. Van Sickels
Aaron Wallender
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Oral and Maxillofacial Surgery / Ausgabe 4/2012
Print ISSN: 1865-1550
Elektronische ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-012-0361-6

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