Thesis (Ph.D.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Oral and Maxillofacial Surgery

Maxillary protrusion is one of the deformities of the upper jaw. Orthodontics or orthodontics combined with anterior segmental osteotomy are the common treatment strategies for this deformity. The hypothesis of this study was that the maxillary bone segment could be gradually moved backward safely by using a tooth-borne specific compression device that causes bone compression at the bony segment interface after performance of surgical bone cuts in cases of anterior maxillary protrusion. Ten patients with skeletal maxillary protrusion were treated by modified subapical maxillary osteotomy. Then the protrusion was gradually set back and fixed in a new position through use of a compression device. After 8 weeks, the device was removed, and soft and hard tissue was evaluated. The average setback of the anterior maxillary segment was found to be 6.8 mm. The ratio of the upper lip to the maxillary incisor retraction was 0.52:1. The nasolabial angle increased with a change of 13.5o. The mentolabial angle increased with a change of 12.5o. This study is the first clinical study in using compression osteogenesis aided by a modified anterior subapical maxillary osteotomy technique in management of skeletal maxillary protrusion which considered as alternative to traditional surgical methods and avoid its complications. It can be used successfully and safely, leading to rapid maximum setback of the anterior maxillary segment with great contact between bone segment, better and gradual hard and soft tissue remodelling, short treatment duration and avoid using plates and screws with its complications

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