Transmucosal posterior segmentation in the context of minimally invasive Le Fort I osteotomy: Technical note

In patients in which posterior segmentation of the maxilla is planned in the context of a minimally invasive Le Fort I osteotomy, accessing the posterior segmentation may tear the soft tissues, causing the minimally invasive approach to become lost, and tissue vascularization may be jeopardized. A technical note is presented for maintaining the original incision length when posterior osteotomies are required in the context of a minimally invasive Le Fort I osteotomy. Two vertical incisions are performed at the level of the premolars, a subperiosteal tunnel is made to access the bone with the piezoelectric device, and then an osteotome is used to complete the osteotomy. It thus may be concluded that this simple and safe additional limited approach can be reproduced in all cases where reaching an anatomical structure in the posterior maxillary region is required in the context of a minimally invasive Le Fort I osteotomy. The described technique offers easy and direct access to the posterior region of the maxilla while maintaining the initial incision length and preserving vascularization through the buccal corridors.