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. 2025 May 27;25(1):809.
doi: 10.1186/s12903-025-06057-4.

Stability of maxilla after segmental Le Fort I osteotomy combined with anterior maxilla clockwise rotation in patients with maxillary hypoplasia: a retrospective study

Fengqi Song  1 , Xinyu Xu  1 , Zili Li  1 , Xiaojing Liu  2
Affiliations

Stability of maxilla after segmental Le Fort I osteotomy combined with anterior maxilla clockwise rotation in patients with maxillary hypoplasia: a retrospective study

Fengqi Song et al. BMC Oral Health. .

Abstract

Background: Segmental Le Fort I osteotomy combined with anterior maxillary clockwise rotation has been proposed as an effective treatment for maxillary hypoplasia. However, the stability of maxilla after the operation remains unknown.

Methods: A total of 30 patients undergoing segmental Le Fort I osteotomy were retrospectively included. The follow-up period was more than one year. The stability of anterior maxilla after clockwise rotation was evaluated by cone beam computed tomography (CBCT) performed before surgery (T0), three days after surgery (T1), and at least one year after surgery (T2), respectively. The key parameters were the postoperative relapse of the anterior maxillary clockwise rotation angle (CRA) and paranasal advancement.

Results: Following segmental Le Fort I osteotomy, the average CRA of the anterior maxilla was 10.02° ± 3.86°, while the mean paranasal advancement was 6.22 ± 1.40 mm. At the one-year follow-up, the relapse of CRA and paranasal advancement were -0.42° ± 2.51° (p = 0.951) and -0.28 ± 0.83 mm (p = 0.08), respectively, suggesting good postoperative stability. Additionally, no significant correlation was found between the intraoperative CRA and its relapse over time.

Conclusion: Segmental Le Fort I osteotomy combined with anterior maxillary clockwise rotation demonstrates favorable stability up to one year postoperatively, making it a reliable approach for the treatment of maxillary hypoplasia.

Keywords: Anterior maxillary clockwise rotation; Maxillary hypoplasia; Segmental Le Fort I osteotomy; Stability.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board of the Stomatology School of Peking University (PKUSSIRB202278111) and performed in accordance with the 1964 Helsinki Declaration and its later amendment. The informed consent was obtained from all subjects or if subjects were under 18, from a parent and/or legal guardian. Consent for publication: Written informed consent was obtained from the individuals for the publication of any potentially identifiable images or data included in this article. Competing interests: The authors declare no competing interests.

Figures

Fig 1
Fig 1
Virtual design of segmental Le Fort I osteotomy. a Initial maxilla and the upper dentition. b Bilateral first premolars were extracted. c The maxilla was divided into the anterior and posterior parts. d The anterior maxillary segments were rotated clockwise centering on the upper incisor point. e The anterior bone segments were rotated in the coronal plane to decrease the steps between canines and second premolars. f The posterior maxilla advanced to close the residual space
Fig 2
Fig 2
Surgical procedure of segmental Le Fort I osteotomy. a Vertical interradicular osteotomies adjacent to the extraction socket. b Removal of the intervening bone. c Palatal osteotomy lines. d Central vertical interradicular osteotomy. e Intermaxillary fixation. f Measurements and verification of paranasal advancement compared to the preoperative virtual design. g Rigid internal fixation. h Autologous bone grafting
Fig. 3
Fig. 3
Reference coordinate system and landmarks used for 3D cephalometry. a Reference coordinate system adhered to a left-handed orientation. b Front view of the twenty landmarks. c Sagittal view of the twenty landmarks and the planes. d Landmarks selection in DICOM data
Fig 4
Fig 4
Correlation analysis results. a Pearson’s correlation between CRAT1-T2 and CRAT0-T1. b Pearson’s correlation between ΔBT1-T2 and ΔBT0-T1. c Pearson’s correlation between of ΔBT1-T2 and ΔU1-FHPT1-T2. P <0.05 was considered statistically significant
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