Sabuncuoglu Fidan, Varol Altan, Sençimen Metin, Olmez Hüseyin
Department of Orthodontics, Gulhane Military Medical Academy Dental Sciences Center, Ankara, Turkey.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Feb;109(2):e13-9. doi: 10.1016/j.tripleo.2009.09.039.
The aim of this paper is to present the outcome of iliac bone block grafts used for paranasal augmentation during bimaxillary orthognathic surgery for the patient with deep concavity of canine fosse.
Preoperative evaluation of the patient, done with 3-dimensional (3D) surgical simulation software, revealed deep bony concavity of paranasal area and insufficient soft tissue improvement when Le Fort I level maxillary advancement was accomplished. The deficient sites were grafted and better profile was achieved with 3D simulation. After the leveling phase, Le Fort I advancement and mandibular setback with sagital split osteotomies were performed. Bony deficiency of paranasal regions were corrected simultaneously with autogenous iliac block grafts to obtain maximum improvement in the profile.
More satisfactory esthetic results were obtained with paranasal augmentation, and acceptable profile was provided for the patient.
Bimaxillary orthognathic surgery combined with augmentation of paranasal area is an efficient method to obtain better aesthetic outcome for patients with severe concave profile. Paranasal augmentation with iliac bone block grafting is a novel technique to ensure favorable soft tissue support and esthetic appearance of the patient.
本文旨在介绍在双颌正颌手术中，使用髂骨块移植对犬齿窝深度凹陷患者进行鼻旁区域增高的效果。
使用三维（3D）手术模拟软件对患者进行术前评估，结果显示鼻旁区域存在严重的骨凹陷，且在完成Le Fort I型上颌骨前移时软组织改善不足。对缺损部位进行移植，并通过3D模拟获得了更好的外形。在整平阶段之后，进行了Le Fort I型前移和下颌矢状劈开截骨后退术。同时使用自体髂骨块移植矫正鼻旁区域的骨缺损，以最大程度改善外形。
鼻旁区域增高获得了更令人满意的美学效果，为患者提供了可接受的外形。
双颌正颌手术联合鼻旁区域增高是一种有效的方法，可为严重凹陷外形的患者获得更好的美学效果。用髂骨块移植进行鼻旁区域增高是一种新颖的技术，可确保患者获得良好的软组织支撑和美观外观。
