Le Fort I advancement osteotomies of 1 cm or more. How safe or stable?

An orthodontic-orthognathic patient with obstructive sleep apnea treated with Le Fort I osteotomy advancement and alar cinch suture combined with a muco-musculo-periosteal V-Y closure to minimize nose deformity

“…There is little consensus regarding large Le Fort I advancement stability and retention. Previous studies 17 reported that Le Fort I maxillary osteotomies with an advancement of 1 cm or more (average ¼ 14 mm, range ¼ 10-22 mm) were safe and stable. In this case, an advancement of approximately 4.5 mm was performed at PNS, and the relapse was 0.5 mm at PNS.…”

Orthognathic Surgery in Cleft Lip and Palate Patients

“…Richardson et al [60] examined all relapse cases among individuals where more than 11 mm of maxillary advancement was applied, and they reported a horizontal relapse rate of 18.75%. Nevertheless, Bhatia et al [61] concluded that relapse rates stayed the same even in maxillary advancement degrees of more than 15 mm (mostly in cleft patients). Yamaguchi et al [62] reported in their systematic review that the mean values of horizontal and vertical relapse were, respectively, 17.9% and 35.4% in orthodontic surgery for cleft patients.…”

“…Wong et al [64] could not find a significant difference between the relapse rates of individuals who received two surgical operations and those who received maxillary advancement surgery only. Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64]. It was reported that usage of grafts has a preventive effect on horizontal maxillary stability with an average of 1.72 mm less relapse [61].…”

“…Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64]. It was reported that usage of grafts has a preventive effect on horizontal maxillary stability with an average of 1.72 mm less relapse [61].…”

“…In an analysis of the USA National Inpatient Samples Database (2012-2013), the rate of emergence for any kind of infectious complication following orthognathic surgery was reported as 7.4% in patients with a craniofacial anomaly and 0.6% in those without a craniofacial anomaly [78]. Recent studies reported rates of from 0to 13.92% for infections emerging after orthognathic surgery in cleft patients without any craniofacial anomaly [61,62,68,70]. In the study that obtained a high rate of incidence as 13.92% despite 5 days of routine antibiotics usage, the authors emphasized the importance of oral hygiene, team collaboration, and patient cooperation [70].…”