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TECHNICAL NOTE

A modified anterior maxillary osteotomy: 15 years experience

Ch. Martis, K. Martis, N. Papadogeorgakis

Department of Oral and Maxillofacial Surgery, Dental School, Athens University, Athens, Greece

SUMMARY. A modified technique of anterior maxillary osteotomy is described, based mainly on the
Wassmund (buccal aspect) and the Wunderer (palatal aspect) methods. Experience of 148 cases operated on
during 15 years is presented.

PROCEDURE

By anterior maxillary osteotomy (or ostectomy), the

anterior portion of the maxilla, after the removal of
both first premolars, is mobilised in a posterior
direction to correct mainly Class II abnormalities.
Of the three commonly used approaches, the
Wassmund technique (Wassmund, 1935) maintains
labial and palatal pedicles to the anterior segment,
the osteotomies or ostectomies being carried out
through tunnels. In the Wunderer technique
(Wunderer, 1962), after a transpalatal incision, the
premaxilla is fractured and relies on its labial pedicle
alone. The Cupar technique (Cupar, 1954), the
down fracture method, relies entirely on the palatal Fig. 2 - The vertical ostectomy is performed through the
pedicle . postextraction sockets (vertical tunnel).
In our modified technique (Martis, 1975), the
vestibular osteotomy or ostectomy takes place
through the postextraction sockets via two vertical
buccal tunnels (Figs 1 & 2), and via a horizontal
labial tunnel through a vertical midline incision of
the mucoperiosteum (Fig. 3). The palatal approach

Fig. 1 - Diagram of the technique showing the vestibular (vertical Fig. 3 - The horizontal osteotomy is performed through the
and horizontal) tunnels and the midline incision. mucoperiosteal (horizontal tunnel).

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214 British Journal of Oral and Maxillofacial Surgery

involves a total flap (transpalatal incision) similar to Wassmund, M. (1935). Lehrbuch der Praktischen Chirurgie des
Mundes und der Kiefer. Leipzig: Meusser.
Wunderer’s method. Through the midline incision, a
Wunderer, S. (1962). Die Prognathieoperation Mittels Frontal
two-piece segmental osteotomy may be carried out Gesteilten Maxillafragment. Osterreichische Zeitschriftfiir
in order to achieve a better dental occlusion. Stomatologie, 59,98.
This technique has been successfully used in 148
patients since 1973 without any serious postoperative
The Authors
problems, and presents the following advantages. It
maintains intact the buccal mucosa and periosteum Ch. Martis DDS, MD
K. Martis DDS
without vertical incisions, thereby ensuring better
N. Papadogeorgakis DDS, MD, MSc
blood supply to the dento-alveolar segment, and Department of Oral and Maxillofacial Surgery
avoids folding of the palatal mucosa. Intermaxillary Dental School
fixation is not necessary and relapse was negligible. Athens University
Athens. Greece

References Correspondence and requests for offprints to Professor C. Martis,

Department of Oral and Maxillofacial Surgery, Dental Faculty,
Cupar, I. (1954). Die Chirurgische Behandlung der Forum-und University of Athens, 2 Thivon Street, Athens 115 27,
Stellungs-Verandemungen des Oberkiefers. Osterreichische Greece.
Zeitschrif fiir Stomatologie, 51,565.
Martis, Ch. (1975). Anterior maxillary osteotomy in the correc- Paper received 13 February 1990
tion of maxillary protrusion. Odontiatriki, 8,216. Accepted 10 December 1990