Treatment of Severe Open Bite Malocclusion with Four-Piece Segmental Horseshoe Le Fort I Osteotomy

Mitsuhiro Hoshijima, Naoki Oka, Tatsushi Matsumura, Seiji Iida, Hiroshi Kamioka

Research output: Contribution to journalArticlepeer-review


Appropriate operations in severe anterior open bite (AOB) cases are extremely complicated to perform because of the multiple surgical procedures involved, the difficulty of predicting posttreatment aesthetics, and the high relapse rate. We herein report a 16-year-old girl with skeletal Class II, severe AOB malocclusion, and crowding with short roots, and aesthetic and functional problems. Four-piece segmental Le Fort I osteotomy with horseshoe osteotomy was performed for maxillary intrusion, and bilateral sagittal split ramus osteotomy (SSRO) and genioplasty were performed for mandibular advancement. The malocclusion and skeletal deformity were significantly improved by the surgical orthodontic treatment. Functional and aesthetic occlusion with an improved facial profile was established, and no further root shortening was observed. Acceptable occlusion and dentition were maintained after a two-year retention period. This strategy of surgical orthodontic treatment with a complicated operative procedure might be effective for correcting certain severe AOB malocclusion cases.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalActa medica Okayama
Issue number1
Publication statusPublished - Feb 1 2023


  • anterior open bite
  • four-piece segmental horseshoe Le Fort I osteotomy
  • severe crowding
  • short roots

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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