Inferior positioning of the maxilla by a Le Fort I osteotomy: a review of 25 patients with vertical maxillary deficiency

Maxillary distraction osteogenesis using Le Fort I osteotomy without intraoperative down-fracture

“…In conventional orthognathic surgery, there is a strong tendency for relapse in cases of advancement combined with extrusion 5,12,15,24,27 . In these cases, vertical relapse ranging from 20% to 30% has been reported, even when internal rigid plate fixation is used in combination with interpositional bone grafts 1,16 .…”

Skeletal stability after inferior maxillary repositioning without interpositional graft

“…4 11 Wire Yes PERSSON et al 10 16 IFR No BAYS 2 13 IFR Yes QUEJADA et al 13 10 Wire Yes WARDROP & WOLFORD 17 11 IFR Yes (HA) ROSEN 15 9 IFR Yes (HA) PROFFIT et al 11 10 Wire Yes ROSEN & ACKERMAN 15 10 IFR Yes (HA) BACKER et al 1 19 IFR No (5) Yes (14) dE MOL VAN OTTERLOO et al 5 25 IFR Yes GURSTEIN et al 6 15 IFR Yes Mean 12.07 This study 8 IFR No…”

“…Eight young adult patients who underwent IRM were studied. The average results of this study were: surgical movement of 4.65 mm at I point, 5.32 mm at anterior nasal spine (ANS) point, and 4.70 mm at A point and relapses of 1.60 mm (35%), 2.23 mm (43%) and 2.10 mm (46%), respectively. It was concluded, that IRM using this type of internal rigid fixation without graft is unstable.…”

Postoperative stability following maxillary downward movement with Le Fort I inclined osteotomy at the lateral nasal cavity wall

“…Procedures such as bilateral coronoidotomy, pterygomasseteric myotomy, and the use of a biteopening appliance before surgery have therefore been introduced to preadapt musculature to an increased length (Ellis et al, 1989). In addition, rigid fixation using a miniplate, interpositional bone grafts with hydroxyapatite or autogenous bone grafts, and simultaneous mandibular surgery to decrease occlusal forces were found to be helpful in increasing stability (Persson et al, 1986;Ellis et al, 1989;Wardrop and Wolford, 1989;De Mol van Otterloo et al, 1996;Proffit et al, 2007).…”

“…Although a rigid fixation system and interpositional bone grafts can contribute to postoperative stability, a mean long-term relapse in stability of more than 20% is still observed (Persson et al, 1986;De Mol van Otterloo et al, 1996;Perez et al, 1997). The lack of long-term stability may be due to insufficient bone contact at the osteotomy site, thus preventing primary bone healing (Jünger et al, 2003).…”