Maxillary Deficiencies

  • Jeffrey C. Posnick


A person with skeletal Class III malocclusion may exhibit either maxillary deficiency, mandibular excess, or a combination of the two. When maxillary deficiency is the primary morphologic problem, it may be in association with clefting (UCLP, BCLP, or ICP) or a more complex craniofacial syndrome (e.g., Apert, Crouzon, Pfeiffer, Kleeblatt—Schaeddel, or Binder’s). Until the late 1960s, when Dr. Tessier developed the field of craniofacial surgery and Obwegeser introduced and Bell refined the Le Fort I osteotomy, the concept of surgical management of maxillary deficiency was of only theoretical interest. With these refinements in surgical technique maxillary deficiency is approached directly, rather than selecting a mandibular osteotomy as a camouflage technique to avoid “extensive” surgery on the upper jaw. Bimaxillary osteotomies are currently performed whenever indicated to give the best functional and aesthetic result.


Anterior Nasal Spine Hemifacial Microsomia Mandibular Osteotomy Maxillary Osteotomy Interpositional Graft 
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© Springer Science+Business Media New York 1997

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  • Jeffrey C. Posnick

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