Simultaneous 3-Dimensional Le Fort I/Distraction Osteogenesis Technique: Positional Changes

Le Fort I Osteotomy for Maxillary Repositioning and Distraction Techniques

“…The first technique allows a simultaneous correction in the three planes of the space in one surgical operation, but it is considered one of the least stable orthognatic procedure (Phillips et al, 1992;Pinto, 2009). …”

“…Other negative aspects of this technique are the difficulties found in obtaining large amount of expansion because of the palatal fibromucosa traction, bone fragment tipping, root damage risks in the three peaces segmentation, vascular risks of bone necrosis for premaxilla fragment after wide deperiostation of the palatal bone for allowing segmental movements and difficulties in bone fragment managing at the fixation time during surgery (Pinto, 2009;Quejada et al, 1986;Lanigan et al, 1990).…”

“…Other unfavourable occurrences associated with the LFI-E are severe intra and post operative haemorrhage after transsectioning of the descending palatine or other large blood vessels, oroantral or oronasal fistulas, permanent mobility the maxillary fragments and loss of gingival papillae after large immediate widening of the bone fragments (Pinto, 2009). …”

“…To overtake this problems and combine the best features of the two techniques (stability for osteodistraction osteogenesis and histogenesis in the maxillary distraction by bone borne appliance and one stage expansion and maxillary repositioning by a the LFI-E) a new technique was developed by the Author: a Le Fort I Osteotomy for Maxillary Advancement and Palatal Distraction in 1 Stage (Pinto, 2009;Cortese et al, 2009). …”

“…Segmented Le Fort I with down fracture with expansion and three-dimensional maxillary repositioning (LFI-E) -Surgical Assisted Rapid Maxillary Expansion by incomplete Le Fort I osteotomy with dental borne devices Hyrax (SARME-dental) -Surgical Assisted Rapid Maxillary Expansion by incomplete Le Fort I osteotomy with bone borne devices (SARME-bone) -Le Fort I osteotomy with down fracture, three-dimensional maxillary repositioning and distraction osteogenesis with dental borne device (LFI-DO-dental) -Le Fort I osteotomy with down fracture, three-dimensional maxillary repositioning and distraction osteogenesis with bone borne devices (LFI-DO-bone) -Le Fort I osteotomy with down fracture, three-dimensional maxillary repositioning and distraction osteogenesis with rigid bone borne devices (LFI-DO-bone-rigid) (Charezinsky et al, 2009;Cortese, 2009Cortese, , 2010Cortese, , 2011Pinto et al, 2009). …”