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. 2002 Jul;94(1):18-23.
doi: 10.1067/moe.2002.126076.

Stability of the Le Fort I osteotomy for maxillary advancement using rigid fixation and porous block hydroxyapatite grafting

Pushkar Mehra  1 , Vanessa Castro, Rogerio Z Freitas, Larry M Wolford
Affiliations

Stability of the Le Fort I osteotomy for maxillary advancement using rigid fixation and porous block hydroxyapatite grafting

Pushkar Mehra et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jul.

Abstract

Purpose: The purpose of this study was to evaluate the stability of maxillary advancement using bone plates for skeletal stabilization and porous block hydroxyapatite (PBHA) as a bone graft substitute for interpositional grafting.

Patients and methods: The records of 78 patients (55 female, 23 male) with a diagnosis of anteroposterior maxillary hypoplasia were retrospectively evaluated. All patients underwent greater than 5 mm Le Fort I maxillary advancement with rigid fixation and PBHA interpositional grafting. The study sample was divided into 3 groups on the basis of the concurrent superior or inferior positioning of the maxillary incisors. Presurgery (T1), immediately postsurgery (T2), and longest follow-up (T3) lateral cephalometric tracings were superimposed to analyze for horizontal and vertical changes at the following landmarks: (1) point A, (2) incisal edge of the maxillary incisor, and (3) mesial cusp tip of maxillary first molar.

Results: The maxilla was inferiorly repositioned in 27 patients, superiorly repositioned in 21 patients, and advanced horizontally without a significant vertical change in 30 patients. All groups showed 0.5 mm or less horizontal and vertical relapse. There was no statistically significant difference between the 3 groups.

Conclusions: Maxillary advancement with Le Fort 1 osteotomies by using rigid fixation and interpositional PBHA grafting is a stable and predictable procedure regardless of the direction of vertical maxillary movement.

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