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CASE REPORT
Year : 2020  |  Volume : 14  |  Issue : 2  |  Page : 89-91

Lefort I osteotomy in combination with modified Wassmund technique: A new combination for surgery- first orthognathic approach


Department of Dental Surgery Oral Health Sciences, Division of Oral and Maxillofacial Surgery, Armed Forces Medical College, Pune, Maharashtra, India

Correspondence Address:
Abhishek Mishra
Department of Dental Surgery Oral Health Sciences, Division of Oral and Maxillofacial Surgery, Armed Forces Medical College, Pune - 411 040, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JODD.JODD_13_20

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Objective: The aim of this technical note is to present a unique combination of orthognathic surgery which incorporates Wassmund technique and Lefort I osteotomy a part of surgery- first orthognathic approach (SFOA) in prognathic maxilla. Methods: Usually, the SFOA indications are minimally involved skeletal discrepancy and most often procedure is bilateral sagittal split ramus osteotomy (BSSRO) for setback or Lefort I osteotomy with superior repositioning. The current report illustrated SFOA in case of gummy smiling with maxillary anteroposterior excess. We have used Lefort I osteotomy in conjunction with Wassmund procedure (incorporating our own modification) for setback of premaxilla in SFOA. Results: The gummy smile was reduced from 9 mm to 3 mm with excellent occlusion in one surgery with improved psychological benefit to the patient. Conclusion: In contrast to the limited skeletal abnormality as an indication of SFOA, the current report presentation reveals a unique technique for dealing with a large skeletal discrepancy with the combination of Lefort I osteotomy and Wassmund technique. A growing acceptance in surgical and orthodontic communities toward SFOA lead an increasing demand in the patients with wide range of skeletal deformity correction in a short period of time. The surgeons should not restrict his horizon to BSSRO or Lefort I osteotomy in SFOA. The comprehensive knowledge of different surgical technique can widened the extent of SFOA.


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