Angelillo J C, Dolan E A
Ann Plast Surg. 1982 Jan;8(1):64-70. doi: 10.1097/00000637-198201000-00010.
The surgical correction of vertical maxillary excess is a relatively new technique. Vertical maxillary excess (VME) may exist alone or in combination with a horizontal mandibular deficiency with or without an anterior open bite. The facial contour is characterized by a long, tapering face with anterior and posterior maxillary overgrowth, a narrow alar base, and lip in competence. Cephalometric analysis demonstrates steep mandibular and occlusal planes in relationship to the cranial base, and increase in facial height, and retroposition of the mandible. Evaluation of study models exhibits increased alveolar bone height, a high palatal vault, and a narrow maxillary arch. The dental relationship may be Class I, II, or III, with Class II being the most common. Orthodontic treatment before surgery consists of correct alignment of the teeth and removal of those dental compensations that preclude good dental interdigitation at surgery. Regardless of the surgical procedure, accurate preoperative planning based on careful evaluation of skeletal, dental, and soft tissue features in conjunction with correct orthodontic surgical sequencing is the key to a satisfactory result. The "downfracturing" or Le Fort I maxillary osteotomy for superior repositioning of the maxilla is the surgical procedure of choice for vertical maxillary excess. Two-, three-, or four-segment maxillary osteotomies can be done in conjunction with the Le Fort I osteotomy without jeopardizing healing capacity.
垂直上颌骨过长的外科矫治是一项相对较新的技术。垂直上颌骨过长（VME）可能单独存在，或与水平下颌骨发育不足合并存在，伴有或不伴有前牙开颌。面部轮廓的特征为脸长且呈锥形，上颌骨前后部过度生长，鼻翼基底狭窄，唇部功能不全。头影测量分析显示下颌平面和咬合平面相对于颅底陡峭，面高增加，下颌后缩。研究模型评估显示牙槽骨高度增加、腭穹隆高、上颌弓狭窄。牙关系可能为I类、II类或III类，其中II类最为常见。手术前的正畸治疗包括牙齿的正确排齐以及消除那些妨碍手术中牙齿良好交错咬合的牙齿代偿。无论采用何种手术方法，基于对骨骼、牙齿和软组织特征的仔细评估并结合正确的正畸 - 外科手术顺序进行准确的术前规划是取得满意效果的关键。“下行折断”或Le Fort I型上颌骨截骨术用于上颌骨的上移复位，是治疗垂直上颌骨过长的首选手术方法。两段、三段或四段上颌骨截骨术可与Le Fort I型截骨术联合进行，而不影响愈合能力。
