Two-Piece Multisegmental Le Fort I Osteotomy With 2 CAD/CAM Splints and a Real-Time Navigation System

Multisegmental Le Fort I osteotomy can be performed in the treatment of both excessive maxillary protrusion and an excessively narrow maxillary arch. Although combined anterior maxillary segmental and Le Fort I osteotomies are commonly performed as a multisegmental procedure, the accuracy of segmental repositioning may be insufficient. The aim of this study was to evaluate the accuracy of segmental repositioning after multisegmental Le Fort I osteotomy performed using 2 splints and a real-time navigation system. This study included patients who underwent 2-piece segmental Le Fort I osteotomy at a single institution between April 1, 2023, and August 31, 2026. Repositioning accuracy was assessed based on the gap between 6 reference points (bilateral central incisors, canines, and first molars) as seen on preoperative simulation and postoperative computed tomography data. A total of 7 females were included in this study. The lateral repositioning accuracy ranged from 0.33 to 0.46 mm. The gap in the anteroposterior direction was <1 mm, similar to that in the vertical direction. Three-dimensionally, the gaps of each reference point ranged from 1.10 to 1.40 mm, and there was no statistical difference among reference point (P=0.899) or region (P=0.675). The utilization of 2 splints and a real-time navigation system may improve the accuracy of segmental repositioning in 2-piece multisegmental Le Fort I osteotomies.