Retained upper third molars during Le Fort I osteotomy with downfracture.

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery

Background:

• The management of upper third molars during Le Fort I osteotomy is a critical consideration.
• Existing literature discusses risks associated with lower third molars in mandibular osteotomies, but less on upper wisdom teeth in maxillary procedures.

Purpose of the Study:

• To evaluate the impact of upper wisdom teeth presence on Le Fort I osteotomy outcomes.
• To determine if wisdom teeth extraction influences surgical duration and complication rates.

Main Methods:

• A comparative study of two groups (20 patients each) undergoing Le Fort I osteotomy.
• Group 1: Le Fort I osteotomy with upper third molars in situ.
• Group 2: Le Fort I osteotomy after upper third molar extraction.

Main Results:

• In the group with wisdom teeth present, extraction was needed in 5 cases, prolonging surgical time.
• Complications like bleeding, bone irregularities, and neurological injuries were noted in both groups, with varying frequencies.
• Hemorrhage from vascular injuries prolonged surgical time in the extraction group.

Conclusions:

• The presence of upper wisdom teeth requires careful evaluation before Le Fort I osteotomy.
• Surgeons should consider the potential impact of wisdom teeth on surgical planning and execution.
• This study aims to assist novice surgeons in approaching Le Fort I osteotomies involving third molars.