Pulp sensibility and pulp necrosis after Le Fort I osteotomy

A longitudinal study comprising 617 teeth in 51 patients was carried out to determine the frequency of pulp necrosis and loss of pulpal sensibility after Le Fort I osteotomy. A negative pulpal sensibility was found in 39 (6%) teeth after an average follow-up period of 28 months, range 11-59 months. Development of pulp necrosis, determined by pulp testing and periapical radiolucency, was only demonstrated in 3 (0.5%) teeth. The extent of horizontal or vertical displacement of the maxilla had no influence on pulpal sensibility. Teeth adjacent to a vertical interdental osteotomy showed a significantly higher frequency of negative reactions compared to the group without an interdental osteotomy (p = 0.002). The canines demonstrated a significantly greater number of teeth with a negative sensibility reaction compared to the other tooth types. A close relationship between the apex of the canines and a wire osteosynthesis was demonstrated to have significant importance for pulpal sensibility.