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Simultaneous 3-dimensional Le Fort I/distraction osteogenesis technique: positional changes.

Lécio P Pinto1, William H Bell, Stephen Chu

  • 1Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|December 17, 2008
PubMed
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Simultaneous 3-dimensional Le Fort I osteotomy and distraction osteogenesis (3D-LFI/DO) effectively repositions the maxilla. This technique achieves significant transverse expansion and acceptable skeletal and dental outcomes without clinical healing issues.

Area of Science:

  • Craniofacial surgery
  • Orthognathic surgery
  • Distraction osteogenesis

Background:

  • Transverse maxillary deficiencies often require complex surgical correction.
  • Traditional methods may have limitations in simultaneously addressing multiple dimensions of maxillary deformity.

Purpose of the Study:

  • To assess the positional changes of the maxilla following simultaneous 3-dimensional Le Fort I osteotomy and distraction osteogenesis (3D-LFI/DO).

Main Methods:

  • Evaluation of 18 patients with transverse maxillary deficiencies and sagittal/vertical deformities.
  • Combined Le Fort I osteotomy for immediate sagittal/vertical repositioning and distraction osteogenesis for transverse expansion.
  • Morphological changes assessed via models, radiographs, and cephalograms pre- and post-surgery.

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Main Results:

  • Achieved Class I canine and molar relationships with satisfactory sagittal and vertical skeletal alignment.
  • Maxillary advancement (1.5-1.8 mm) and vertical repositioning (1.2-2.9 mm) were observed.
  • Significant increases in arch perimeter (5.4 mm) and width (4.2-6.6 mm) with nonparallel expansion.

Conclusions:

  • 3D-LFI/DO enables simultaneous and selective widening, lengthening, and vertical repositioning of the maxilla.
  • The procedure yields acceptable post-treatment skeletal and dental relationships.
  • No significant clinical healing problems were encountered.