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. 2014 Oct 1;5(3):e4.
doi: 10.5037/jomr.2014.5304. eCollection 2014 Jul.

Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

Tue Lindberg Blæhr  1 , Thomas Jensen  1 , Karen Margrethe Due  2 , Bjarne Neumann-Jensen  1
Affiliations

Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

Tue Lindberg Blæhr et al. J Oral Maxillofac Res. .

Abstract

Objectives: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint.

Material and methods: 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral cephalometric radiographs.

Group a: The upper incisor had a mean intrusion of -0.56 mm (SD 0.77; range -2.04 to 1.08 mm) and a mean posterior movement of -0.93 mm (SD 1.03; range -2.52 to 0.96 mm). The mean change in the axial inclination of the upper incisor was -0.33° (SD 2.56; range -6° to 4°) (95% CI: -1.75 to 1.08°). Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm) and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm). The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5°) (95% CI: -1.83 to 1.69°). There was no statistically significant difference in stability between the two groups at the P value 0.05.

Conclusions: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment in segmental Le Fort I osteotomy.

Keywords: LeFort osteotomy; maxillofacial orthognatic surgery; open bite; skeletal fixation.

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Figures

Figure 1
Figure 1
Intraoperative photographs, showing skeletal wires fixed at the symphysis (A) and at the anterior nasal spine (B).
Figure 2
Figure 2
Lateral cephalometric radiograph showing landmarks and reference planes. U1 = upper central incisor tip; S = sella; N = nasion; SNL = sella-nasion line.
See this image and copyright information in PMC

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