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Three-dimensional assessment of root changes after Le Fort I osteotomy
K A Alqahtani1, E Shaheen2, C Politis2
1OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.
Le Fort I osteotomy significantly impacts maxillary tooth root morphology, especially in canines and premolars. Surgeons and orthodontists should consider these root changes during orthognathic surgery planning.
Area of Science:
- Orthodontics and Maxillofacial Surgery
- Dental Imaging and Analysis
Background:
- Orthognathic surgery, particularly Le Fort I osteotomy, is frequently combined with orthodontic treatment.
- Understanding the effects of such procedures on root morphology is crucial for long-term treatment outcomes.
Purpose of the Study:
- To evaluate volumetric, linear, and morphological root changes in maxillary incisors, canines, and premolars after Le Fort I osteotomy.
- To compare root changes between patients undergoing Le Fort I osteotomy and those undergoing bilateral sagittal split osteotomy without maxillary surgery.
Main Methods:
- Retrospective analysis of 60 patients (30 in study group, 30 in control group) undergoing combined orthodontic and orthognathic surgery.
- Utilized Cone-Beam Computed Tomography (CBCT) scans at preoperative, 6-month, 1-year, and 2-year postoperative intervals.
- Employed a fully automated 3D evaluation protocol to assess root changes in maxillary teeth.
Main Results:
- Significant differences in apical and middle root portions were observed between groups at 1 and 2 years post-surgery, with greater changes in the Le Fort I osteotomy group (P < 0.05).
- Increased root remodeling was noted in canines, first, and second premolars in the study group (P < 0.005).
- A positive correlation was found between root remodeling and the extent of maxillary advancement (P < 0.05).
Conclusions:
- Le Fort I osteotomy leads to significant root remodeling in maxillary anterior and premolar teeth.
- The degree of maxillary advancement is positively associated with the extent of root remodeling.
- Findings provide valuable insights for surgeons and orthodontists in managing root changes during orthognathic surgery.
