Post-operative stability of the maxilla treated with Le Fort I and horseshoe osteotomies in bimaxillary surgery

In this study, the post-operative change of the maxilla in six non-cleft patients who underwent combination (Le Fort I and horseshoe) osteotomy for superior repositioning of the maxilla was investigated. In all patients, the maxilla was first osteotomized and fixed with four Luhr plates. No iliac bone graft was applied to the maxilla. A bilateral sagittal split ramus osteotomy of the mandible (BSSRO) was then carried out and titanium screw fixation was performed. No maxillo-mandibular fixation (MMF) with stainless steel wire was used post-operatively in any patient. Lateral cephalograms were obtained pre-operatively, 5 days post-operatively, and 3, 6, and 12 months after surgery. The changes in anterior nasal spine (ANS), point A, upper incisor (U1), and point of maxillary tuberosity (PMT) were examined. The maxillae in the six subjects were repositioned nearly in their planned positions during surgery and no significant post-operative changes in the examined points of the maxilla were found. These results suggest that a combination of a Le Fort I and horseshoe osteotomy is a useful technique for reliable superior repositioning of the maxilla. The post-operative change in the maxilla using this combination osteotomy is comparatively stable.