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[Total osteotomy for maxillary setback. Indications, technique, results].

PURPOSE
Maxillary skeletal protrusion used to be treated by orthodontic treatment or combined surgical and orthodontic treatment consisting in extraction of two maxillary premolars associated with anterior maxillary osteotomy. Although the anterior occlusal result is quite often good, the esthetic impact is often unsatisfactory. Furthermore, these methods do not correct for the generally associated vertical maxillary excess nor for the first molar class II relation.


MATERIAL AND METHODS
This retrospective study included 11 patients who underwent posterior repositioning of the maxilla between 1986 and 2001. The indication for surgery was based on clinical and cephalometric criteria as exposed. Patient evaluation was based on bony stability and relation between hard and soft tissue changes, and changes in hard and soft tissues cephalometric landmarks assessed prior to surgery, post operatively and six months post operatively.


RESULTS
Results were considered quite good with restoration of a first molar Class I relation, restitution of facial harmony and an esthetic soft tissue profile. Cutaneous movements after surgery, the relation between hard and soft tissue changes and rate of relapse are reported.


DISCUSSION
We compared our series with those reported in the literature emphasizing diagnostic and technical difficulties. This method, which provides good healing as well as the good stability can be recommended for surgical treatment of patients with maxillary protrusion associated with vertical maxillary excess.