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Modified Le Fort I osteotomy techniques for vertical maxillary excess: a comparative systematic review.
Sajal Khare1, Veera Bhosale2, Gunika Tayal2
1Department of Orthodontics & Dentofacial Orthopedics, Dental College & Hospital, Bharati Vidyapeeth (Deemed to be) University, Pune, India. kharesajal9@gmail.com.
Oral and Maxillofacial Surgery
|July 12, 2026
Summary
Modified Le Fort I osteotomies offer a safer, effective approach to correcting vertical maxillary excess (VME). These techniques ensure stable outcomes and reduce surgical risks, improving patient satisfaction.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Dentofacial Deformities
Background:
- Vertical maxillary excess (VME) is a common dentofacial deformity causing facial elongation and open bite.
- Conventional Le Fort I osteotomy is effective but carries risks, including potential injury to the descending palatine artery (DPA).
- Modified osteotomy techniques aim to enhance surgical safety and predictability in VME correction.
Purpose of the Study:
- To systematically review and compare the clinical effectiveness, postoperative stability, and safety of modified Le Fort I osteotomy techniques for VME.
- Evaluate various modified Le Fort I osteotomy approaches including horseshoe, pyramidal, and U-shaped techniques.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Medline, Google Scholar, Web of Science) for studies from 2016-2024.
- Included studies focused on adult patients with VME undergoing orthognathic surgery using modified Le Fort I osteotomies.
- Ten studies involving 117 patients were qualitatively synthesized, assessing surgical techniques, complications, repositioning accuracy, and long-term stability.
Main Results:
- Ten studies met inclusion criteria, evaluating modified Le Fort I osteotomies in VME treatment.
- All reviewed modified techniques successfully achieved intended maxillary repositioning without major complications.
- No significant vascular injuries were reported, and skeletal stability was maintained for at least 12 months post-surgery.
Conclusions:
- Modified Le Fort I osteotomies are safe and effective alternatives to conventional methods for VME.
- These techniques reduce surgical risks and ensure stable aesthetic and functional outcomes.
- Personalized technique selection is key for optimizing results and improving patient quality of life in VME management.
