Postoperative skeletal stability and accuracy of a new combined Le Fort I and horseshoe osteotomy for superior repositioning of the maxilla |
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| Authors: | I. Yoshioka A. Khanal M. Kodama N. Furuta K. Tominaga |
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| Affiliation: | 1. Associate Professor, Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany;2. Professor, Sailer Clinic, Zürich, Switzerland;3. Associate Professor, Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany;4. Professor, Department of Orthodontics, University of Cologne, Cologne, Germany;6. Professor, Department of Trauma Surgery, Cologne-Merheim, Germany;5. Professor, Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany;1. PhD Student in Neurosciences and Cell Biology, Federal University of Pará, Belém, PA; Specialist in Oral and Maxillofacial Surgery and Traumatology, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil;2. Postdoctoral Student, Department of Mechanical Engineering, University of Porto, Porto, Portugal; PhD Student, Msc Student, Specialist in Oral and Maxillofacial Surgery and Traumatology, State University of Campinas, São Paulo, SP, Brazil;3. Msc Student, Federal University of Pará, Belém, PA; Resident in Oral and Maxillofacial Surgery, Ophir Loyola Hospital, Belém, PA, Brazil;4. Specialist in Oral and Maxillofacial Surgery, Joao de Barros Barreto Hospital, Belém; Master Student in Oral and Maxillofacial Surgery, Federal University of Pará, Belém, PA, Brazil;1. Resident, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan, China;2. Resident, Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, Dalian, China;3. Resident, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen;4. Resident, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan, China;6. Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan, China;5. Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan, China;1. Oral and Maxillofacial Surgery Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil;2. Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL, USA;3. UNESC School of Dentistry, Criciúma, SC, Brazil;4. Program on Integrated Dental Sciences, Faculty of Dentistry of the University of Cuiabá – UNIC, Cuiabá, Brazil;5. Division of Oral and Maxillofacial Surgery, Department of Otolaryngology – Head and Neck Surgery, and Division of Dentistry, Department of Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA |
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| Abstract: | Postoperative skeletal stability and accuracy were evaluated in a combination of Le Fort I and horseshoe osteotomies for superior repositioning of maxilla in bi-maxillary surgeries in 19 consecutive patients. 9 underwent Le Fort I osteotomy alone (preoperative planned superior movement <3.5 mm). 10 underwent Le Fort I and horseshoe osteotomy (combination group) (preoperative planned superior movement >3.5 mm). The maxilla was osteotomized and fixed with 4 titanium Le Fort plates followed by bilateral sagittal split ramus osteotomy of the mandible, fixed with 2 semi-rigid titanium miniplates. Maxillomandibular fixation was performed for 1 week. Lateral cephalograms were obtained preoperatively, 1 week postoperatively, 3, 6, 12 months later. The changes in point A, point of maxillary tuberosity, and upper molar mesial cusp tip were examined. Discrepancy between the planned and measured superior movement of the maxilla in the Le Fort I and combination groups was 0.30 and 0.23 mm, respectively. The maxillae in both groups were repositioned close to their planned positions during surgery. 1 year later, both groups showed skeletal stability with no significant postoperative changes. When high superior repositioning of the maxilla is indicated, horseshoe osteotomy combined with Le Fort I is reliable and useful for accuracy and postoperative stability. |
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