Surgical treatment of midface deformities

Champy, M

doi:10.1002/hed.2890020603

Cited by 54 publications

(11 citation statements)

References 6 publications

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“…However, long-term surgical correction success for dentofacial deformities depends largely on the stability of surgical movements relating to the amount of maxilla advancement with different palate surgery patterns. A trend toward more relapse was found with larger maxillary advancement in the literature (Araujo et al 1978;Champy 1980;Epker & Schendel 1980;Hörster 1980;Laurie et al 1984;Carlotti & Schendel 1987;Louis et al 1993).…”

Section: Introductionmentioning

confidence: 87%

Biomechanical interactions of different mini-plate fixations and maxilla advancements in the Le Fort I Osteotomy: a finite element analysis

Huang

Lin

2016

Computer Methods in Biomechanics and Biomedical Engineering

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This study investigates the biomechanical interaction of different mini-plate fixation types (shapes/sizes and patterns) with segmental advancement levels on the Le Fort I osteotomy using the non-linear finite element (FE) approach. Nine models were generated under a standard 1-piece LeFort I osteotomy for advancement with 3, 6 and 9 mm distances and four mini-plates with three fixation patterns including LL, LI, and II patterns placed on the maxillae models by integrating computed tomography images and computer-aided design system. The axial and oblique occlusal forces were 250 N applied to each premolar/molar and 125 N applied at 30° inclination to the tooth long axis and from palatal to buccal, respectively. The relative micro-movement values between the two maxillary bone segments and maximum mini-plate stress increased obviously with maxilla advancement increment and the increasing trend can be fitted by exponential curve. The corresponding values in II mini-plate fixation presented apparently high values in all simulated cases. The mini-plate stress concentration locations were found at the bending regions to increase high fracture risk. The mini-plate yield strength can be mapped to a critical (limited) advancement for three types of fixations for safe consideration. This study concluded that L-shaped mini-plates with lateral fixation are recommended to provide better stability. The risk for mini-plate fracture and bone relapse increases when maxillary advancement is larger than a critical value of 5 mm in the Le Fort I osteotomy.

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Section: Introductionmentioning

confidence: 87%

Biomechanical interactions of different mini-plate fixations and maxilla advancements in the Le Fort I Osteotomy: a finite element analysis

Huang

Lin

2016

Computer Methods in Biomechanics and Biomedical Engineering

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“…This is higher value compared with the average amount of relapse in non-CLP patient (10%) during MAL. 4,7,11,17,19,30 The average amount of relapse of maxillary advancement in group 2 was 2.26 mm, which is approximately 21% of the amount of maxillary advancement. Although the amount of maxillary advancement was greater in group 2, there was no significant difference in relapse between two groups.…”

Section: Stability/relapse/overcorrectionmentioning

confidence: 99%

Comparison of Treatment Outcome and Stability Between Distraction Osteogenesis and LeFort I Osteotomy in Cleft Patients With Maxillary Hypoplasia

Baek

Lee²,

Lee³

et al. 2007

Journal of Craniofacial Surgery

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The purpose of this study was to compare treatment outcome and relapse between maxillary advancement surgery with LeFort I osteotomy and maxillary distraction osteogenesis in patients with cleft lip and palate with maxillary hypoplasia. The sample consisted of a maxillary advancement surgery with LeFort I osteotomy group (group 1, N= 14, mean age, 21.7 years) and a maxillary distraction osteogenesis group (group 2, N = 11, mean age, 16.3 years). Lateral cephalograms were taken and traced at presurgery (T0), postsurgery (T1), and postretention (T2). Nine hard and four soft tissue cephalometric variables were measured. Differences in measurements at each stage, treatment outcome (T1-T0), and relapse (T2-T1) were compared between groups with independent t test. Because the amount of surgical movement could affect the amount of relapse, a difference in relapse between two groups was compared by analysis of covariance with the amount of surgical movement as a covariant. Although the amounts of forward movements of A point (P < 0.01), upper incisor (P < 0.001), and upper lip (P < 0.001) during T1-T0 were greater in group 2, there were no significant differences in the amounts of relapse (T2-T1) between the two groups. During T1-T0, counterclockwise rotation of the palatal plane was observed in group 2 as a result of downward movement of posterior nasal spine (PNS) at T1, whereas group 1 had clockwise rotation of palatal plane at T1 because of downward movement of anterior nasal spine (ANS). The amounts of relapse (T2-T1) in vertical movements of PNS and upper incisor were significantly different between the two groups (P < 0.05). The amount of required maxillary advancement, vector control of palatal plane, and vertical position of upper incisor would be important factors when planning a surgical treatment in patients with cleft lip and palate with midface hypoplasia.

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“…The ideal vertical dimension is achieved based on the preoperative plan, but intraoperative approaches may be considered in some cases [35]. Maxillary osteotomy regions are fixed on all zygomatic buttresses and apertures by using titanium plates and screws based on the principles described by Luhr [48,49]. If a graft has been used, an extra microplate is additionally applied to stabilize each interpositional cortico-cancellous (iliac) graft.…”

Section: Modified Le Fort I Osteotomy (Two-segment)mentioning

confidence: 99%

Orthognathic Surgery in Cleft Lip and Palate Patients

Yılmaz¹,

Demirkaya²

2020

Current Treatment of Cleft Lip and Palate

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Cleft lip and palate patients often exhibit severe dentofacial deformities that necessitate orthognathic surgery. Orthognathic surgery in these patients generally includes not only maxillary advancement, but also sagittal, horizontal, and vertical movement of both jaws. Surgical planning and execution presents many difficulties, caused by the presence of extensive scar tissues from previous surgeries, tissue deficiencies, the difficulty of aligning multiple segments of bone and soft tissues. Other challenges in cleft patients are complications related to post-surgical airway, speech, velopharyngeal insufficiency, nerve damage, and infections. This review is focused on orthognathic surgery in cleft lip and palate patients, management, techniques, success, and complications.

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Surgical treatment of midface deformities

Cited by 54 publications

References 6 publications

Biomechanical interactions of different mini-plate fixations and maxilla advancements in the Le Fort I Osteotomy: a finite element analysis

Biomechanical interactions of different mini-plate fixations and maxilla advancements in the Le Fort I Osteotomy: a finite element analysis

Comparison of Treatment Outcome and Stability Between Distraction Osteogenesis and LeFort I Osteotomy in Cleft Patients With Maxillary Hypoplasia

Orthognathic Surgery in Cleft Lip and Palate Patients

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