Le Fort III osteotomy or distraction osteogenesis imperfecta: your choice
John H Phillips1, Alan K George, Brian Tompson
1Hospital for Sick Children, Center for Craniofacial Care and Research, Toronto, Ontario, Canada. jphillips002@sympatico.ca
Background:
Traditional Le Fort III osteotomies have been described by several authors; however, few have reported the distances advanced and stability over time.
Methods:
The authors assessed their last 30 Le Fort III osteotomies with respect to the immediate incisor advancement achieved at surgery and long-term advancement as measured at the A-point from preoperative and postoperative cephalometric tracings. The authors then compared their results with those in the literature for Le Fort III distraction techniques. Comparisons were made with respect to distraction distance maintained, the need for bone grafting, airway results, morbidity, and cost.
Results:
The mean incisor advancement at the time of surgery as recorded in 14 patients was 21.6 mm (range, 12 to 28 mm). The long-term cephalometric A-point measurements in 14 patients demonstrated a mean of 14.14 mm (range, 8 to 25 mm).
Conclusion:
The authors conclude that, at the present time, no significant improvement in the results using Le Fort III distraction osteogenesis when compared with traditional methods has been shown.
