Correction of vertical maxillary excess by superior repositioning of the maxilla.

Vertical maxillary excess (VME) is frequently referred to as one variation of maxillo-mandibular discrepancy, which is often identified by excessive display of incisors and gingiva during smiling. This anomaly is corrected surgically by superior maxillary impaction, which can be combined by other procedures such as, anterior maxillary segmental osteotomy to relieve the maxillary protrusion, or mandibular osteotomy in the form of ramus surgery, or subapical osteotomy to correct the maxillary-mandibular relationship, and to obtain functional occlusion. Adjunctive procedures are undertaken to counteract the associated soft tissue changes, and to establish functional and esthetic facial balance. This article subjectively reports the results of superior repositioning of the maxilla in 4 patients with excessive maxillary growth, with or without other skeletal deformities. The remarkable improvements in facial appearance perceived by patients suggest the best value of orthognathic surgery in the correction of VME by means of maxillary impaction osteotomy and other adjunctive procedures.