[Stability of Le Fort I impaction osteotomies]

Abstract

Introduction: Long-term results of Le Fort I osteotomy with vertical impaction for maxillary vertical excess may be not stable. We had for aim to analyze postoperative maxillary and dental displacement after a Le Fort I vertical impaction osteotomy, to identify causes of relapse.

Patients and methods: A clinical and radiological evaluation was made on postoperative occlusion (early and late). The position of three bone (O: lower orbit; P: greatest palatine convexity; T: lowest part of the mandibular foramen) and of three dental landmarks (I: occlusal edge of the upper incisor; i: occlusal edge of the lower incisor; m: first molar distal vestibular cuspid) was measured in a standardized method on pre-surgical, early and late (1 to 2.5 years) postoperative cephalometric X rays. Eighteen patients were operated by the same surgeon for maxillary anterior vertical excess and underwent Le Fort I impaction osteotomy, alone or associated with a mandibular osteotomy. Stability was defined by a postoperatory displacement smaller than 1mm.

Results: All patients had stable bone landmarks. Three patients had unstable dental landmarks due to relapse.

Discussion: Impaction maxillary osteotomy provides stable bone results for maxillary facial height excess. Unsatisfactory outcome is always due to postoperative dental and alveolar displacement. These results correlate to published data.