Demétrio Maurício Silva, Barbosa Saulo de Matos, Lima Raphaela Kassia, Medeiros Yuri de Lima, Marliére Daniel Amaral Alves, Assis Neuza Maria Souza Picorelli
Department of Dentistry, Dom Bosco University, São Luís, Brazil.
Division of Dentistry, Faculty of Dentistry São Leopoldo Mandic, Campinas, Brazil.
J Korean Assoc Oral Maxillofac Surg. 2025 Apr 30;51(2):108-116. doi: 10.5125/jkaoms.2025.51.2.108.
Patients with anteroposterior maxillary deficiency and mandibular prognathism associated with a long-face pattern exhibit reduced anterior and lateral projection of the zygomaticomaxillary complex. Several techniques have been combined with orthognathic surgery to enhance the volume and definition of this region, such as zygomatic osteotomy. Two female patients, aged 22 (Case A) and 29 (Case B), with class II (Case A) and III (Case B) malocclusion, respectively, complained about facial aesthetics due to a long face and lack of malar projection. Le Fort I osteotomy to advance the maxilla, bilateral mandibular ramus osteotomy to set back the mandible, mentoplasty for advancement and width reduction, and zygomatic osteotomy were erformed. The patients underwent computed tomography scans, and superimposed images indicated that a volumetric increase in the malar region was achieved through the anterolateral movement of the zygomatic body. Improvements were noted in the paranasal region (Case A), better alignment of the upper and lower lips, the chin region, and an improved chin-neckline ratio (in both cases). The patients were satisfied with the results and are under follow-up. In summary, zygomatic osteotomy combined with orthognathic surgery proved to be a predictable and safe strategy for increasing malar prominence, with satisfactory aesthetic and functional outcomes.
患有上颌前后部发育不足以及伴有长面型的下颌前突的患者，其颧上颌复合体的前部和侧方投影减小。已有多种技术与正颌外科手术联合使用，以增加该区域的体积并改善其轮廓，例如颧骨截骨术。两名女性患者，分别为22岁（病例A）和29岁（病例B），分别患有安氏II类（病例A）和安氏III类（病例B）错牙合畸形，她们因脸长和颧骨突出不足而抱怨面部美观问题。实施了Le Fort I型截骨术以推进上颌骨，双侧下颌升支截骨术以后退下颌骨，颏成形术以推进并减小宽度，以及颧骨截骨术。患者接受了计算机断层扫描，叠加图像显示通过颧骨体的前外侧移动实现了颧骨区域的体积增加。在鼻旁区域（病例A）有改善，上下唇、颏部的对齐更好，颏颈比例得到改善（两个病例均如此）。患者对结果满意，目前正在接受随访。总之，颧骨截骨术联合正颌外科手术被证明是一种可预测且安全的增加颧骨突出度的策略，具有令人满意的美学和功能效果。
