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Published on: October 12, 2016
Changes in bone blood flow in segmental LeFort I osteotomies
Winfried Bernhard Kretschmer1, Grigore Baciut, Mihaela Baciut
1Department of Oral and Maxillofacial Surgery, Marienhospital, Stuttgart, Germany. winfriedkretschmer@vinzenz.de
Summary
Multisegmental LeFort I osteotomies significantly reduce bone blood flow (BBF). However, moderate maxillary movements do not significantly impact blood supply to the bone.
Area of Science:
- Oral and Maxillofacial Surgery
- Craniofacial Surgery
- Surgical Research
Background:
- LeFort I osteotomy is a common surgical procedure for correcting midface deformities.
- Understanding the impact of surgical technique on bone healing is crucial for patient outcomes.
- Bone blood flow (BBF) is a key indicator of tissue viability and healing potential.
Purpose of the Study:
- To investigate the effect of maxillary segmentation and segment movement during LeFort I osteotomies on bone blood flow (BBF).
- To determine if the magnitude of maxillary repositioning influences BBF.
- To assess BBF changes at different stages of the surgical procedure.
Main Methods:
- Prospective cohort study involving patients undergoing 3-piece LeFort I osteotomies with simultaneous bilateral sagittal split osteotomy (BSSO).
- Maxillary BBF was measured using laser Doppler at four sites: premaxilla, right and left maxillary segments, and mandible.
- Measurements were taken before surgery (T1), after osteotomy (T2), and after fixation (T3).
Main Results:
- A statistically significant decrease in maxillary BBF was observed between T1 and T2, and between T2 and T3.
- No significant differences in BBF were found among the three maxillary regions.
- The magnitude of maxillary movement (categorized into high/low risk groups) did not significantly affect BBF.
Conclusions:
- Multisegmental LeFort I osteotomies result in a significant reduction in maxillary bone blood flow.
- Moderate movements of the maxilla during these procedures do not appear to compromise blood supply.
- Further research may explore long-term implications and optimal surgical parameters.
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