:Combined Multiple Segmental Le Fort I and Sagittal Split Ramus Osteotomy

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A 21-year-old female presented a class III malocclusion with facial asymmetry. The patient expressed complaints about the appearance of cross bite from the right lateral incisor to the second molar, and the asymmetric face according to the shifted mandible to the right. The problem lists from the initial record were as follows: 1. Excessive mandibular growth, 2. Crossbite and dental compensation, 3. Shifted mandible to the right, 4. Occlusal plane tilted transversely by 2.5 degrees, 5. Narrowed maxilla, 6. Crowding.<BR>Orthodontic treatment followed by surgical procedures was performed. After extraction of the upper first premolars, a 022 edgewise appliance was used. After alignment and canine retraction of the upper arch, multiple segmental Le Fort I osteotomy and sagittal split ramus osteotomy were carried out. In the maxilla, the upper arch was divided into 3 segments after the down fracture (Two segments including canine, premolar, and molars, and one segment including incisors), for the purpose of correcting the narrowed maxilla, transverse decompensation, correction of the occlusal plane, and space closing. In the mandible, bilateral SSRO was performed for the purpose of correcting the excessive mandibular growth, and the shifted mandible. In the post-operative period, detailing and finishing were performed, and finally fairly good occlusion was obtained.
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