Maxillary segmentation in Le Fort I osteotomy: a meta‑analysis of complications compared with one‑piece surgery

The objective of this paper was to evaluate intraoperative and postoperative complications associated with maxillary segmentation in Le Fort I osteotomy and compare them with conventional one-piece Le Fort I. A meta-analysis was performed using studies published in the last 15 years from PubMed, Cochrane, and SciELO databases. Observational human studies reporting complications of segmented and conventional Le Fort I osteotomies were included. A random effects model was used to calculate pooled complication rates and relative risks. Seven studies comprising 3307 patients were included; 873 underwent segmented Le Fort I osteotomy. The complication rate was higher in segmented surgery (11.6%) than in one-piece procedures (6.8%). Removal of osteosynthesis material and dental injury were the most common complications. Oronasal fistula and segmental necrosis occurred exclusively in segmented cases. Segmented Le Fort I osteotomy increases the risk of postoperative complications, particularly those related to vascular compromise and intersegmental stability. These findings support careful case selection and meticulous technique when performing maxillary segmentation.