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

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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.

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References

  1. 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 54:607–12

    Article  PubMed  CAS  Google Scholar 

  2. 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 54:491–8

    Article  PubMed  CAS  Google Scholar 

  3. Proffit WR, Turvey TA, Phillips C (1996) Orthognathic surgery: a hierarchy of stability. Int J Adult Orthodon Orthognath Surg 11:191–204

    PubMed  CAS  Google Scholar 

  4. 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 3:21

    Article  PubMed  Google Scholar 

  5. Proffit WR, Bailey LJ, Phillips C, Turvey TA (2000) Long-term stability of surgical open-bite correction by Le Fort I osteotomy. Angle Orthod 70:112–7

    PubMed  CAS  Google Scholar 

  6. 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 34:238–43

    Article  PubMed  Google Scholar 

  7. 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 134:60–6

    Article  Google Scholar 

  8. 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.e10

    Article  Google Scholar 

  9. Jensen U, Ruf S (2010) Success rate of anterior open-bite orthodontic orthognathic surgical treatment. Am J Orthod Dentofac Orthop 138:716–9

    Article  Google Scholar 

  10. 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 89:19–23

    Article  PubMed  Google Scholar 

  11. 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 97:52–7

    Article  CAS  Google Scholar 

  12. 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 67:231–41

    Article  PubMed  CAS  Google Scholar 

  13. 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 106:434–40

    Article  CAS  Google Scholar 

  14. 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 106:304–16

    Article  CAS  Google Scholar 

  15. 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 104:160–9

    Article  PubMed  Google Scholar 

  16. Bisase B, Johnson P, Stacey M (2010) Closure of the anterior open bite using mandibular sagittal split osteotomy. Brit J Oral Maxillofac Surg 48:352–355

    Article  CAS  Google Scholar 

  17. 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 45:56–64

    Article  CAS  Google Scholar 

  18. Prinsell JR (2002) Maxillomandibular advancement surgery for obstructive sleep apnea syndrome. J Am Dent Assoc 133:1489–97

    PubMed  Google Scholar 

  19. 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 39:541–7

    Article  PubMed  CAS  Google Scholar 

  20. 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 69:677–86

    Article  PubMed  Google Scholar 

  21. 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 65:6–12

    Article  PubMed  Google Scholar 

  22. 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 70:1659–77

    Article  PubMed  Google Scholar 

  23. Carpagnano GE (2011) Exhaled breath analysis and sleep. J Clin Sleep Med 7(5 Suppl):S34–7

    PubMed  Google Scholar 

  24. 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 33:535–42

    Article  PubMed  CAS  Google Scholar 

  25. 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

    Google Scholar 

  26. 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 23:127–31

    Article  PubMed  CAS  Google Scholar 

  27. Cutbirth M, Van Sickels JE, Thrash WJ (1998) Condylar resorption after bicortical screw fixation of mandibular advancement. J Oral Maxillofac Surg 56:178–82

    Article  PubMed  CAS  Google Scholar 

  28. 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 119:368–81

    Article  CAS  Google Scholar 

  29. Araujo A, Schendel SA, Wolford LM, Epker BN (1978) Total maxillary advancement with and without bone grafting. J Oral Surg 36:849–58

    PubMed  CAS  Google Scholar 

  30. 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 66:1580–5

    Article  PubMed  Google Scholar 

  31. 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 94:18–23

    Article  PubMed  Google Scholar 

  32. 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 25:264–267

    Article  PubMed  CAS  Google Scholar 

  33. 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 39:1059–65

    Article  PubMed  CAS  Google Scholar 

  34. Lye KW, Waite PD, Wang D, Sittitavornwong S (2008) Predictability of prebent advancement plates for use in maxillomandibular advancement surgery. J Oral Maxillofac Surg 66:1625–9

    Article  PubMed  Google Scholar 

  35. Araujo MM, Waite PD, Lemons JE (2001) Strength analysis of Le Fort I osteotomy fixation: titanium versus resorbable plates. J Oral Maxillofac Surg 59:1034–9

    Article  PubMed  CAS  Google Scholar 

  36. 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 68:2765–9

    Article  PubMed  Google Scholar 

  37. Peterson GP, Haug RH, Van Sickels J (2005) A biomechanical evaluation of bilateral sagittal ramus osteotomy fixation techniques. J Oral Maxillofac Surg 63:1317–24

    Article  PubMed  Google Scholar 

  38. Joss CU, Vassalli IM (2009) Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review. J Oral Maxillofac Surg 67:301–13

    Article  PubMed  Google Scholar 

  39. Gassmann CJ, Van Sickels JE, Thrash WJ (1990) Causes, location, and timing of relapse following rigid fixation after mandibular advancement. J Oral Maxillofac Surg 48:450–4

    Article  PubMed  CAS  Google Scholar 

  40. Van Sickels JE, Richardson DA (1996) Stability of orthognathic surgery: a review of rigid fixation. Br J Oral Maxillofac Surg 34:279–85

    Article  PubMed  Google Scholar 

  41. Van Sickels JE (1991) A comparative study of bicortical screws and suspension wires versus bicortical screws in large mandibular advancements. J Oral Maxillofac Surg 49:1293–8

    Article  PubMed  Google Scholar 

  42. 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 67:809–17

    Article  PubMed  Google Scholar 

  43. 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. 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 137:605–14

    Article  Google Scholar 

  45. Wriedt S, Buhl V, Al-Nawas B, Wehrbein H (2009) Combined treatment of open bite—long-term evaluation and relapse factors. J Orofac Orthop 70:318–26

    Article  PubMed  Google Scholar 

  46. 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 27:81–91

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Joseph E. Van Sickels.

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Van Sickels, J.E., Wallender, A. Closure of anterior open bites with mandibular surgery: advantages and disadvantages of this approach. Oral Maxillofac Surg 16, 361–367 (2012). https://doi.org/10.1007/s10006-012-0361-6

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  • DOI: https://doi.org/10.1007/s10006-012-0361-6

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