A Case of Skeletal Maxillary Protrusion with Open Bite and Hypoplasia of the Condyle Treated Using Maxillary Surgery Alone

Abstract

Surgical correction for skeletal maxillary protrusion is frequently associated with various risks, such as relapse and progressive condylar resorption (PCR). In addition, affected patients with a deformity of the condylar head have increased risk of these complications. We report a case of skeletal maxillary protrusion associated with hypoplasia of the bilateral mandibular condyles, in which a favorable outcome was attained by utilizing a combination of Le Fort I osteotomy and anterior segmental maxillary osteotomy procedures along with planned mandibular autorotation. A 26-year-old woman visited the Department of Orthodontic Dentistry at our hospital with complaints of maxillary protrusion and anterior open bite. The patient was diagnosed with hypoplasia of the bilateral mandibular condyles and maxillary protrusion associated with an open bite of the anterior teeth by several radiographic and orthodontic examinations, and was referred to our department for surgical correction. Preoperative orthodontic treatment was initially performed for 1 year 8 months, after which she underwent orthognathic surgery. The operation was two segmental Le Fort I osteotomy (a combination of Le Fort I and anterior segmental maxillary osteotomy), along with mandibular autorotation. At more than 2 years after surgery, the patient expressed satisfaction with changes in facial appearance and stable occlusion also remained. Accordingly, we consider that these surgical procedures may be effective for patients with maxillary protrusion associated with hypoplasia of the bilateral mandibular condyles.