Anterior maxillary osteotomy is frequently applied to skeletal Class II
cases with maxillary protrusion. In addition to the anteroposterior
problem, these cases are often accompanied with a long midfacial appearance
and display of incisors and gingiva during smiling. In the application
of anterior maxillary osteotomy to such patients, it is necessary
to move the anterior maxillary segments upward as well as
backward. Since the upward movement occasionally interferes with
the intranasal endotracheal tube, orotracheal intubation is recommended
for the operation. Recently, the use of a resin replica of the
mandibular dental arch was introduced to place the anterior maxillary
segment correctly in the planned position and to obtain the correct
occlusion. This article reports on 3 maxillary protrusive skeletal
Class II patients with deep overbites and vertical esthetic problems
treated by this method. The treatment results show that all 3 patients
exhibited large upward and backward movements of the anterior
maxillary segments and desirable facial profiles, with a reduction of
the deep overbites after the treatment. This case report demonstrates
that the anterior maxillary osteotomy under orotracheal intubation
with the use of a resin replica is a useful method to treat maxillary protrusive
skeletal Class II patients with a large alveolar height.
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