Le Fort III osteotomy for severe dentofacial deformity correction associated with hypoplasia of the midface

ABSTRACT The combination of orthodontic therapy and orthognathic surgery is a well-established treatment modality for the correction of dentofacial deformities. When these deformities are more severe, involving hypoplastic midface, surgical techniques not used routinely in the treatment of facial changes are required, such as the Le Fort III osteotomy or variations of this technique. Few studies have reported the use of this technique or its modifications in non-syndromic patients. This paper demonstrates the orthodontic-surgical resolution of a patient with dentofacial deformity with severe malocclusion Class III, involving midface hypoplasia, with a modification technique of a Le Fort III osteotomy associated with Le Fort I and sagittal of the rami osteotomies. After three years of postoperative follow-up, the patient demonstrates significant improvement in chewing ability, no functional complaints, and high satisfaction with the aesthetics and improved quality of life.

【摘要】正畸治疗（orthodontic therapy）联合正颌外科手术（orthognathic surgery）是矫正牙颌面畸形（dentofacial deformities）的成熟治疗方案。当畸形程度较为严重、累及面中份发育不全时，需采用面部畸形常规治疗中未常规使用的手术技术，例如Le Fort III截骨术（Le Fort III osteotomy）或该术式的改良版本。目前鲜有研究报道该技术及其改良术式在非综合征患者（non-syndromic patients）中的应用。本文报告1例伴严重安氏III类错𬌗、面中份发育不全的牙颌面畸形患者，采用Le Fort III截骨术联合Le Fort I截骨术（Le Fort I osteotomy）及下颌支矢状劈开截骨术（sagittal ramus osteotomies）的改良术式进行正畸-正颌联合治疗。术后随访3年，患者咀嚼功能显著改善，无功能性不适主诉，对美观效果满意度较高，生活质量亦得到显著提升。