title: Palatal approach to the anterior maxillary sandwich osteotomy.
abstract: OBJECTIVE
  This report describes a technique used to increase vertical height and anterior prominence of the anterior maxilla.
  
  
  METHODS
  Two cases illustrate the palatal approach to segmental osteotomy with interpositional bone grafting (sandwich osteotomy) of the anterior maxilla. The palatal approach allows the segment to be moved anteriorly and inferiorly. This is in contrast to the buccal approach, in which the tight palatal tissue creates a vector of force toward the palate. The vascular pedicle for the segmental bone flap using the palatal approach is the labial mucosa and musculature.
  
  
  RESULTS
  The maxillary alveolar ridge in case 1 was advanced 4 mm anteriorly and 5 mm inferiorly. In case 2, the ridge was moved 4 mm anteriorly and 6 mm inferiorly. Cases 1 and 2 were later successfully restored with dental implants.
  
  
  CONCLUSIONS
  The palatal approach to the anterior maxillary osteotomy was found to be effective in 2 cases that required anterior and inferior repositioning of the anterior maxilla.
authors.affiliation: tularebell@gmail.com
authors.forename: Robert E
authors.initials: RE
authors.lastname: Bell
mesh_terms: D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous; D003799:Dental Stress Analysis; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D021362:Palate, Hard / Q000601:surgery*; D013524:Surgical Flaps