education

1. AMO

2. What is it?
• A technique of osteotomy to manage defects in pre
maxillary region
• First reported by Cohn stock- 1921
 Indications:
• Bimaxillary protrusion
• Protruded maxillary teeth with normal inclinatIon to
alveolar bone
• Anterior open bite
• When orthodontic management not feasible (eg- pt
not willing for prolonged wait for change)

3. Vasculature of anterior maxilla

4. Wassamund technique(1935)
• Preservation of both
buccal n palatal pedicles
• Buccal as well as
anterior vertical
incisions with tunnelling
• No transpalatal incision,
occasional midpalatal
sagittal incision

5. Wunderer’s technique (1963)
• Similar to wassamund, but
with transpalatal incision
• For anterio- posterior
correction
• Relies on intact buccal
pedicle
• Superior fracturing of
premaxilla
• Greatest reduction in
anterior maxillary blood
supply

6. Cupar’s osteotomy (1954)
• Management of vertical
excess
• Buccal vestibular
incision
• down fracture of
maxilla
• Vestibular
circumferential n labial
flap
• Direct visualisation

8. Epker’s technique (1977)
• Modified Cupar’s
• Down fracturing of
anterior maxilla
• only labial flaps and
vertical tunnels labial to
the teeth to be
extracted, which are
usually premolars on
both sides

9. Complications of AMO
• Loss of teeth vitality (by not maintaining a safe
distance of 6mm from apex of roots)
• periodontal defects
• Communication with nasal cavity or antrum
• Occlusal step deformity

10. Post cleft maxillary hypoplasia
management

11. SAME
• Surgically Assisted
Maxillary Expansion
• Majorly for transverse
defects

12. Distraction Osteogenesis

13. AMO with DO
Pre op (HYRAX) 3 MONTHS Post op