Maxillary stability following downgraft and/or advancement procedures with stabilization using rigid fixation and...

The stability of results using bone plates for skeletal stabilization and porous block hydroxyapatite implants as a bone graft substitute were evaluated in maxillary downgrafts, maxillary advancements, and modified LeFort III midface advancements. The records of 24 patients with greater than 5 mm of forward or downward movement were evaluated cephalometrically, analyzing the presurgical, immediate postsurgical, and longest follow-up radiographs. The 11 maxillary downgraft, 14 maxillary advancement, and three midface advancement procedures all showed less than 1 mm of relapse. Biopsies of the porous block hydroxyapatite grafts were taken on six patients in this study at 6 to 10 months postsurgery. All showed connective tissue ingrowth and 11.3% to 36.1% bone ingrowth throughout the pores of the implants, and no inflammatory response.