Comparison between 2- and 4-plate fixation in Le Fort I osteotomy: a mixed methods systematic review

Area of Science:

• Orthognathic Surgery
• Maxillofacial Reconstruction
• Skeletal Stability

Background:

• Postsurgical skeletal stability is critical for successful orthognathic surgery outcomes.
• Precision maxillofacial surgery aims to improve stability and reduce complications.
• Le Fort I osteotomy is a common procedure in orthognathic surgery.

Purpose of the Study:

• To evaluate the impact of 2 vs. 4 plate fixation techniques on skeletal stability after Le Fort I osteotomy.
• To compare relapse risks between different fixation methods in orthognathic surgery.

Main Methods:

• A mixed-methods approach including systematic review, in silico analysis, and in vitro studies.
• Systematic review followed Joanna Briggs Institute and GRIMM guidelines.
• Biomechanical and relapse risk assessments were performed.

Main Results:

• Meta-analysis showed no significant difference in skeletal stability between 2- and 4-plate fixation.
• Biomechanical analysis indicated increased relapse risk with 2-plate fixation for 3 mm advancement.
• 4-plate fixation was associated with stability for 10 mm advancement.

Conclusions:

• Both 2- and 4-plate fixation methods are viable for Le Fort I osteotomy.
• Four-plate fixation provides superior stability for significant maxillary advancements.
• Further research with larger sample sizes is needed to confirm findings and guide clinical practice.