@article{oai:niigata-u.repo.nii.ac.jp:02000545,
 author = {小島, 拓 and Kojima, Taku and 加藤, 祐介 and Kato, Yusuke and 船山, 昭典 and Funayama, Akinori and 三上, 俊彦 and Mikami, Toshihiko and 倉部, 華奈 and Kurabe, Kana and 原, 省司 and Hara, Shoji and 朝日藤, 寿一 and Asahito, Toshikazu and 八巻, 正樹 and Yamaki, Masaki and 齋藤, 功 and Saito, Isao and 小林, 正治 and Kobayashi, Tadaharu},
 issue = {1},
 journal = {新潟歯学会雑誌},
 month = {Jul},
 note = {長顔を呈する患者では，口唇の閉鎖が困難となり安静時でも上顎歯肉の露出を伴うことがある。そのような症例において良好な顔貌を獲得するには，上顎骨を上方に大きく移動させる必要があるが，通常のLe Fort I型骨切り術で上顎骨を挙上する場合，下行口蓋動脈周囲の骨や下鼻甲介が障害となり上方移動が困難となることがある。今回われわれは，著しい長顔を呈する顎変形症患者に対し馬蹄形骨切り併用Le Fort I型骨切り術を施行して上顎骨を上方移動することで，良好な顔貌が得られたのでその概要を報告する。患者は20歳の女性で，口唇の閉鎖困難を主訴に当院を受診した。著しい長顔を呈する顎変形症と診断し，上下顎移動術によって上下顎骨を上方移動させ顔面高の短縮を図る方針とした。術前矯正治療終了後に馬蹄形骨切り併用Le Fort I型骨切り術と両側下顎枝矢状分割法を施行し，上顎骨全体を8mm上方に移動させた。その1年後にオトガイ形成術を施行し，下顔面高を5mm短縮させた。初回手術から2年経過時において前歯部でわずかな開咬を認めたが，良好な顔貌が維持され口唇の閉鎖が容易になり患者の満足が得られた。, A patient with long face had difficulty in lip closure and the maxillary gingiva was exposed even under a resting condition. In such cases, major superior repositioning of the maxilla is necessary to obtain a good appearance. However, major maxillary upward movement by normal Le Fort I osteotomy is sometimes difficult because the bony interference around the descending palatine artery and the inferior nasal concha disturb the movement. We report a patient with severe long face who was treated by horseshoe Le Fort I osteotomy for major superior repositioning of the maxilla that resulted in a good appearance. A 20-year-old female visited our hospital with the complaint of difficulty closing her lips. She was diagnosed as jaw deformity with severe long face and was considered an indication for maxilla-mandibular osteotomy for superior repositioning of the maxilla and mandible to reduce facial height. After preoperative orthodontic treatment, horseshoe Le Fort I osteotomy and bilateral sagittal splitting ramus osteotomy were performed to move the whole maxillary bone 8mm upward. Additionally, 5mm reduction genioplasty was undergone one year later. Two years after the first operation, a slight open bite in anterior teeth was recognized, but a good facial appearance was maintained and lip closure had become easy and the patient was satisfied with the results.},
 pages = {21--26},
 title = {著しい長顔を呈する顎変形症患者に対し馬蹄形骨切り併用Le Fort I型骨切り術を施行した1例},
 volume = {46},
 year = {2016}
}