Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Unilateral bimaxillary vertical elongation by maxillary distraction osteogenesis and mandibular sagittal split ramus osteotomy: a case report

상악 골신장술과 하악 상행지시상분할술을 이용한 편측 상하악골 수직 증가술: 증례보고

  • Jung, Young-Eun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University Dental Hospital, Dental Research Institute, BK21 for Craniomaxillofacial Life Science, Seoul National University) ;
  • Yang, Hoon-Joo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University Dental Hospital, Dental Research Institute, BK21 for Craniomaxillofacial Life Science, Seoul National University) ;
  • Hwang, Soon-Jung (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University Dental Hospital, Dental Research Institute, BK21 for Craniomaxillofacial Life Science, Seoul National University)
  • 정영언 (서울대학교 치의학대학원 구강악안면외과학교실, 치학연구소, 두개악안면 생명과학 BK 21, 서울대학교 치과병원 구강악안면외과) ;
  • 양훈주 (서울대학교 치의학대학원 구강악안면외과학교실, 치학연구소, 두개악안면 생명과학 BK 21, 서울대학교 치과병원 구강악안면외과) ;
  • 황순정 (서울대학교 치의학대학원 구강악안면외과학교실, 치학연구소, 두개악안면 생명과학 BK 21, 서울대학교 치과병원 구강악안면외과)
  • Received : 2011.08.17
  • Accepted : 2011.11.22
  • Published : 2011.12.31
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Abstract

Maxillary canting and vertical shortening of the unilateral mandibular ramus height is common in cases of severe facial asymmetry. Normally, mandibular distraction osteogenesis (DO) with horizontal osteotomy at the ascending ramus is used for vertical lengthening of the mandibular ramus to correct facial asymmetry with an absolute shortened ascending ramus. In this case report, vertical lengthening of the ascending ramus was performed successfully with unilateral DO and sagittal split ramus osteotomy (SSRO), where the posterior part of the distal segment can be distracted simultaneously in an inferior direction with maxillary DO, resulting in a lengthening of the medial pterygoid muscle. This case describes the acquired unilateral mandibular hypoplasia caused by a condylar fracture at an early age, which resulted in abnormal mandibular development that ultimately caused severe facial trismus. The treatment of this case included two-stage surgery consisting of bimaxillary distraction osteogenesis for gradual lengthening of the unilateral facial height followed by secondary orthognathic surgery to correct the transverse asymmetry. At the one year follow-up after SSRO, the vertical length was maintained without complications.

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References

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