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Background <p>This technical note describes several modifications of the palatal horseshoe osteotomy (HO) technique designed to enable safe and accurate maxillary repositioning, particularly in cases requiring superior or posterior movement. Conventional HO procedures carry a risk of injury to the descending palatine vessels (DPV) and maxillary molar roots.</p> Methods <p>To minimize these risks, we employed preoperative multiplanar reconstructed CT (MPR-CT) imaging to plan osteotomy lines that avoid anatomical interference and used an ultrasonic bone scalpel for precise cutting. Modifications include paramedian osteotomy to eliminate bony interference, partial HO for limited posterior or superior repositioning, and unilateral HO for asymmetric maxillary excess. </p> Results <p>These adaptations enhance surgical safety, flexibility, and preservation of nasal airway volume by reducing anatomical interference and facilitation controlled maxillary movement.</p> Conclusions <p>These techniques are based on operative experience and anatomical considerations; comparative clinical data are still limited and further evaluation is required.</p>

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Technical Modifications of Palatal Horseshoe Osteotomy to Facilitate Safe Maxillary Impaction: A Technical Note

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Manabu Habu,
  • Jing Yuan,
  • Taishi Ohtani,
  • Hiroki Tsurushima,
  • Osamu Takahashi,
  • Izumi Yoshioka,
  • Kazuhiro Tominaga

摘要

Background

This technical note describes several modifications of the palatal horseshoe osteotomy (HO) technique designed to enable safe and accurate maxillary repositioning, particularly in cases requiring superior or posterior movement. Conventional HO procedures carry a risk of injury to the descending palatine vessels (DPV) and maxillary molar roots.

Methods

To minimize these risks, we employed preoperative multiplanar reconstructed CT (MPR-CT) imaging to plan osteotomy lines that avoid anatomical interference and used an ultrasonic bone scalpel for precise cutting. Modifications include paramedian osteotomy to eliminate bony interference, partial HO for limited posterior or superior repositioning, and unilateral HO for asymmetric maxillary excess.

Results

These adaptations enhance surgical safety, flexibility, and preservation of nasal airway volume by reducing anatomical interference and facilitation controlled maxillary movement.

Conclusions

These techniques are based on operative experience and anatomical considerations; comparative clinical data are still limited and further evaluation is required.