[Horseshoe Le Fort I osteotomy].

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery

Context:

• Le Fort I impaction osteotomy can be challenging due to intranasal volume, specifically the lower turbinates, limiting maxillary impaction.
• Horseshoe osteotomy presents a viable alternative surgical approach in such complex cases.

Purpose:

• To describe the horseshoe osteotomy technique as an alternative to Le Fort I osteotomy for significant maxillary impactions.
• To highlight its application in pre-implantation surgery for maxillary crest modification.

Summary:

• The horseshoe osteotomy involves lowering the pyriform aperture and nasal floor, resecting maxillary sinus walls, and impacting the dental arch after dissecting palatine mucosa and disjoining the pterygomaxillary suture.
• This method enables substantial maxillary impaction without freeing the vomer or cutting nasal fossa lateral walls.

Impact:

• This technique is beneficial for pre-implantation surgery, allowing maxillary crest lowering in edentulate patients and increasing crestal height post-bone grafting.
• It serves as an effective alternative to conventional Le Fort I osteotomy for substantial impactions, provided adequate alveolar bone height is present.