Comparison of the postoperative stability after repositioning of the maxilla with Le Fort I osteotomy using four- versus two-plate fixation

Le Fort I osteotomy procedures requires miniplates fixation in both the aperture piriformis and zygomaticomaxillary buttress.

The purpose of this study was to compare the postoperative stability of the Le Fort I osteotomy using four-plate versus two-plate fixation.

This study involved 39 Class III patients who underwent one-piece Le Fort I osteotomy with bilateral sagittal split ramus osteotomy. In group I, four miniplates were placed at the apertura piriformis and the zygomaticomaxillary buttress, whereas, in group II, fixation was achieved with two miniplates bilaterally placed at the piriform apertura with no posterior fixation. Linear and angular measurements included maxillary sagittal and vertical positions. The primary outcome of this study was stability, as recorded by lateral cephalometric measurements of the preoperative, immediately postoperative and late postoperative periods.

Significant immediate postsurgical changes were found in both groups. In the late postoperative cephalometric measurements, all skeletal parameters showed significant stability in groups I and II. In terms of vertical and sagittal relapse, there was no significant difference between the four-plate and two-plate groups (p1=0.686 and p2=0.513, respectively).

A good postoperative stability can be obtained with a two-plate fixation after one-piece Le Fort I osteotomy.