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Stability of maxilla downgrafting after rigid or wire fixation
P W Major1, G E Philippson, K E Glover
1University of Alberta, Edmonton, Canada.
Purpose:
This article compares the long-term outcomes of rigid internal fixation with wire fixation.
Patients And Methods:
In this retrospective study, nine cases of vertical midface augmentation in which rigid fixation was used were compared with 11 cases with wire fixation. One surgeon completed all cases for the rigid fixation group, and another surgeon completed the cases in the wire fixation group.
Results:
Follow-up was 16 +/- 11 months for the rigid fixation group and 20 +/- 12 months for the wire fixation group. Inferior movement at the anterior portion of the maxilla was 7.0 +/- 2.9 mm with rigid fixation and 4.5 +/- 3.6 mm with wire fixation (P < .05). Postsurgical superior movement (relapse) was 0.4 +/- 0.4 mm with rigid fixation and 2.4 +/- 2.4 mm with wire fixation (P < .01). Inferior movement at the posterior maxilla was 3.1 +/- 0.2 mm with rigid fixation and 2.8 +/- 2.3 mm with wire fixation. Postsurgical superior movement (relapse) was 0.8 +/- 0.4 mm with rigid fixation and 0.5 +/- 2.3 mm with wire fixation, which was not significantly different.
Conclusion:
This comparison showed downgrafting of the maxilla using autogenous bone harvested from the iliac crest and rigid internal fixation to be a predictable and stable procedure.