[Studies following Wassmund osteotomy in the modified down-fracture technic]

The down-fracture technique enables three-dimensional displacement of the maxilla in the Le Fort-I plane as well as its simultaneous multisegmentation. Using a semirigid technique of fixation with miniplates, a stable result can be obtained in orthodontic follow-up treatment without tendency to vertical and sagittal recurrence. The transverse deviations detected are interpreted primarily as functional adaptations. In cranial displacement of the maxilla by more than 10 mm, there is a risk of esthetic problems involving the region of the upper lip, the soft tissues of the nose and the cheek. The rate of subjective postoperative disorders is small. In the event of damage to the descending palatine artery, areas of necrosis may occur in the region of the anterior lateral teeth. The disorders of sensitivity of the gum and the gingiva typical for such operations do not result in subjective discomfort. The rate of iatrogenic damage to teeth is 5.6% in the patients followed up. Because of high acceptance of therapy and the low incidence of complications on the one hand as well as the various possibilities of therapy on the other hand, the down-fracture technique is regarded as the most important method of operation in orthodontic surgery at present.