The authors evaluated the surgical area, indications, and procedures
for segmental dentoalveolar osteotomy carried out on 16 jaws in 13
patients treated at the Department of Oral and Maxillofacial Surgery,
Kobe University Graduate School of Medicine, between 1990 and 2001.
Osteotomy was indicated mainly in cases where tooth repositioning
by orthodontic treatment was limited, where social conditions (eg,
age, time, finances) precluded orthodontic treatment, or where revision
of orthodontic or surgical treatment was required. In cases of
maxillary anterior segmental dentoalveolar osteotomy, the modified
Wunderer method was used, where after an incision was made in the
palatal mucosa, a mucoperiosteal flap was abraded as much as possible
until the area of the osteotomy on the palatal side could be visualized.
In maxillary posterior segmental dentoalveolar osteotomy, the
operation was carried out in 2 stages because of the risk of necrosis of
the bone fragments. In the first stage, an osteotomy was carried out on
the vestibular side, since the vestibular gingival pedicle was intact. In
the second stage, 3 weeks later, another osteotomy was performed
after the palatal mucoperiosteal flap was abraded to visualize the
area of the osteotomy as well as that of the maxillary anterior segmental
dentoalveolar osteotomy.
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