AMO, or anterior maxillary osteotomy, is a surgical technique used to correct defects in the premaxillary region through osteotomy of the anterior maxilla. It was first reported in 1921 and can be used to treat bimaxillary protrusion, protruded maxillary teeth, and anterior open bite when orthodontic treatment is not feasible. There are various techniques for AMO, such as the Wassamund technique from 1935 which preserves buccal and palatal pedicles, and the Wunderer's technique from 1963 which uses a transpalatal incision. Potential complications of AMO include loss of tooth vitality, periodontal defects, communication with the nasal cavity or maxillary sinus, and occlusal

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