Effects of Le Fort I osteotomy on maxillary anterior teeth: a 5-year follow up of 42 cases

Abstract

Aim: The aim of this study was to assess the vitality of maxillary anterior teeth following Le Fort I osteotomy.

Materials and methods: A total of 245 maxillary anterior teeth in 42 patients were examined by several pulp vitality tests before surgery and 1 to 5 years postoperatively. Data were recorded in SPSS and were statistically analyzed by using Pearson, chi(2), and Fisher exact tests.

Results: This study showed a significant number (91%) of the maxillary anterior teeth to be sensitive to cold, 88.8% to electrical pulp test, and 89.4% to heat tests 12 months to 5 years following Le Fort I osteotomy. A total of 8 teeth (3.2%) had undergone root canal therapy (RCT) because they were nonvital and had developed apical lesions. Pain on percussion was observed in 5.7% of the teeth. External resorption was significantly associated with insensitivity (P < .05). Orthodontic therapy adds to this especially if excessive force is applied.

Conclusion: A significant number of teeth had sensitivity after Le Fort I osteotomy. Only 3.2% needed RCT. When all vitality tests were negative, we used periapical radiolucency as the main criterion for judging pulp necrosis requiring RCT. It should be stressed that the outcomes of a single test cannot be considered as a reliable indicator for the presence or absence of pulpal or periapical disease or for RCT. Although the complications following Le Fort I osteotomy are few, follow-up is mandatory.

Figure 1

Age distribution of the patients in this study. It is of note that most patients undergoing surgery were in the 2nd to 3rd decades of life.