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Distance-dependent accuracy in Le Fort I maxillary repositioning procedures.

T Dreiseidler1, L Ritter2, M Zirk1

  • 1Dept. of Craniomaxillofacial and Plastic Surgery, University of Cologne, Germany.

The British Journal of Oral & Maxillofacial Surgery
|August 28, 2017
PubMed
Summary

Maxillary repositioning accuracy decreases with longer surgical movements, especially in the sagittal plane. This study confirms that greater distances moved during Le Fort I osteotomies lead to less precise outcomes.

Keywords:
3D analysisLe Fort I osteotomymaxillary repositioningorthognathic surgery

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Biomedical Engineering

Background:

  • Maxillary repositioning procedures aim for precise skeletal movements.
  • The influence of repositioning distance on surgical accuracy remains under-investigated.

Purpose of the Study:

  • To evaluate the correlation between planned maxillary repositioning distances and achieved accuracy.
  • To identify planes and anatomical landmarks most affected by repositioning distance.

Main Methods:

  • Analysis of Cone-beam CT scans from 92 patients undergoing Le Fort I osteotomies.
  • Measurement of maxillary displacement in axial, sagittal, and transverse planes.
  • Statistical analysis using Pearson's correlation coefficient to compare planned vs. achieved movements.

Main Results:

  • Significant correlations between planned distance and achieved accuracy were found, particularly in the sagittal plane at the first molar landmarks (M1L and M1R).
  • Accuracy decreased as the planned repositioning distance increased, with observed errors up to 12mm for planned movements of 0-4mm.
  • The sagittal plane showed the weakest correlation, indicating greater potential for error in this dimension.

Conclusions:

  • Surgical accuracy in wafer-based maxillary repositioning is distance-dependent.
  • Longer repositioning distances are associated with reduced accuracy, especially in the sagittal plane and affecting molar regions.