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Published on: February 17, 2023
Three dimensional assessment of root changes after multi-segments Le Fort I osteotomy
Khalid Ayidh Alqahtani1, Eman Shaheen2, Oliver Da Costa Senior2
1OMFS IMPATH Research Group, Department of Imaging & 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.
This study found no significant differences in maxillary tooth root changes between one-segment and multi-segment Le Fort I osteotomies. Greater maxillary advancement correlated with increased root remodeling after orthognathic surgery.
Area of Science:
- Orthodontics and Maxillofacial Surgery
- Dental Imaging and Biomechanics
Background:
- Orthognathic surgery, specifically Le Fort I osteotomy, is used to correct jaw discrepancies.
- Understanding the impact of different osteotomy techniques on maxillary tooth roots is crucial for treatment planning and outcomes.
- Previous research has not fully elucidated the specific effects of multi-segment versus one-segment Le Fort I osteotomies on root morphology.
Purpose of the Study:
- To quantitatively assess linear, volumetric, and morphological changes in maxillary tooth roots after multi-segment Le Fort I osteotomy.
- To compare root remodeling between multi-segment and one-segment Le Fort I osteotomies.
- To investigate patient- and treatment-related factors influencing root remodeling post-surgery.
Main Methods:
- Retrospective analysis of 60 patients (590 teeth) undergoing combined orthodontic and orthognathic surgery.
- Comparison between a multi-segment (2- or 3-segment) Le Fort I osteotomy group (n=30) and a one-segment Le Fort I osteotomy group (n=30).
- Three-dimensional (3D) analysis of root changes using pre-operative and 1- and 2-year post-operative cone beam computed tomography (CBCT) scans with an automated method.
Main Results:
- No statistically significant differences were observed in linear, volumetric, or morphological root measurements between the multi-segment and one-segment Le Fort I osteotomy groups.
- A positive correlation was found between the extent of maxillary advancement and the degree of root remodeling.
- Increased maxillary advancement was associated with more pronounced root remodeling.
Conclusions:
- The type of Le Fort I osteotomy (one-segment vs. multi-segment) does not significantly impact maxillary tooth root remodeling.
- Maxillary advancement magnitude is a key factor influencing root remodeling following combined orthodontic and orthognathic surgery.
- Surgeons can utilize these findings to better anticipate and manage root remodeling in patients undergoing Le Fort I osteotomies.
