Severe midface and maxillary hypoplasia in non-cleft and non-syndromic patients: A 2-stage surgical strategy using distraction osteogenesis and orthognathic surgery.

Severe midface and maxillary hypoplasia can have an impact on an individual, either on the appearance, functions or psychologically. Based on literature review, severe maxillary hypoplasia with more than 25.0 mm reverse overjet in non-cleft and non-syndromic patients is very rare. It is more often seen in cleft lip and palate and syndromic patients. When the magnitude of correction exceeds the limit of what a single orthognathic surgery can achieve, multiple surgeries would be required, involving different surgical techniques. The authors report two rare cases of non-syndromic nor cleft severe hypoplastic midface and maxilla with 26.0 mm and 27.0 mm reverse overjet, respectively, treated with 2-stage surgery involving maxillary distraction osteogenesis and orthognathic surgery. Both cases recorded reasonably clinical and functional outcomes. The significance of both surgical interventions is further discussed.