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Does preoperative joint space affect accuracy in splint-based Le Fort I osteotomy?
M D Han1, A Tavasoli2, R Malaki3
1Department of Oral and Maxillofacial Surgery, University of Illinois Chicago College of Dentistry, Chicago, IL, USA.
International Journal of Oral and Maxillofacial Surgery
|January 31, 2026
Summary
Preoperative joint space (JS) variations impact splint-based Le Fort I osteotomy (LFI) accuracy. Greater superior and posterior JS correlated with specific surgical errors, highlighting the need for preoperative evaluation in Le Fort I osteotomy.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Surgical Accuracy
Background:
- Splint-based Le Fort I osteotomy (LFI) accuracy can be affected by condyle-fossa relationships.
- Understanding preoperative joint space (JS) impact is crucial for optimizing surgical outcomes.
Purpose of the Study:
- To investigate the influence of preoperative joint space (JS) on surgical errors in splint-based maxilla-first LFI.
- To quantify the relationship between JS measurements and surgical inaccuracies.
Main Methods:
- Retrospective analysis of patients undergoing splint-based maxilla-first LFI.
- Preoperative JS measured via cone-beam computed tomography (CBCT).
- Surgical movements (linear and angular) assessed using voxel-based registration.
Main Results:
- Mean linear and angular errors were 0.82-1.18 mm and 0.87-1.21°, respectively.
- Superior JS correlated with mediolateral error (P=0.020); posterior JS correlated with anteroposterior error (P=0.019).
- Regression models identified specific JS values predicting surgical errors.
Conclusions:
- Vertical and anteroposterior preoperative JS significantly affect maxilla-first splint-based LFI accuracy.
- Preoperative JS assessment can identify patients at higher risk for surgical errors.
- Routine evaluation of preoperative joint space is recommended for improved surgical precision.
Keywords:
Dentofacial deformitiesLe Fort osteotomyMalocclusionOrthognathic surgeryTemporomandibular jointMore Related Videos
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