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Correction of vertical maxillary deficiency: stability and soft tissue changes

W H Bell, G B Scheideman

    Journal of Oral Surgery (American Dental Association : 1965)
    |September 1, 1981
    PubMed
    Summary

    Le Fort I osteotomy with bone grafts for vertical maxillary deficiency showed about 2 mm of relapse, mainly early after surgery. Maxillary stability improved later, enhancing facial aesthetics.

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    Area of Science:

    • Oral and Maxillofacial Surgery
    • Orthognathic Surgery
    • Craniofacial Reconstruction

    Background:

    • Vertical maxillary deficiency (VMD) presents a significant challenge in achieving optimal facial aesthetics and function.
    • Surgical correction using Le Fort I osteotomy with interpositional bone grafting is a common treatment for VMD.
    • Assessing long-term stability and outcomes is crucial for refining surgical techniques.

    Purpose of the Study:

    • To evaluate the stability and cephalometric changes following Le Fort I osteotomy and autogenous interpositional bone grafting in adults with VMD.
    • To identify the timing and magnitude of skeletal relapse after surgical correction of VMD.
    • To assess the impact of the surgical procedure on facial height and aesthetic outcomes.

    Main Methods:

    • Retrospective cephalometric analysis of 11 adult patients with VMD treated with Le Fort I osteotomy and bone grafting.
    • Measurement of maxillary positional changes and facial height at various postoperative intervals.
    • Evaluation of upper lip length, maxillary incisor exposure, and smile line characteristics.

    Main Results:

    • A consistent skeletal relapse of approximately 2 mm was observed, primarily within the first two to three months postoperatively.
    • Minimal further positional changes of the maxilla occurred after the initial early relapse period.
    • Improvements in maxillary incisor display, smile line, and lip-to-tooth relationships were noted, with slight upper lip lengthening.

    Conclusions:

    • Le Fort I osteotomy with autogenous bone grafting for VMD demonstrates significant early postoperative relapse.
    • Maxillary stability is largely achieved after the initial three-month period, with minimal late changes.
    • Future surgical technique modifications should focus on enhancing interosseous fixation to improve early postoperative stability and minimize relapse.

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