Stability following superior repositioning of the maxilla by Le Fort I osteotomy: five-year follow-up.
Changes in dental and skeletal relationships were evaluated 5 years postsurgically in 49 patients whose maxilla had been superiorly repositioned by a Le Fort I osteotomy. All of the patients had at least 2 mm of intrusion at the maxillary incisor and molar; none had a mandibular ramus osteotomy or other osteotomy except genioplasty. Only 6.5% had 2 mm or greater of net vertical change in skeletal or dental landmarks at 1 year postsurgery. From 1 to 5 years postsurgery, minimal changes in skeletal and dental landmarks occurred in the majority of the patients, but approximately 25% of the patients showed 2 mm or more of downward movement of the maxilla and/or eruption of maxillary teeth, leading to downward-backward rotation of the mandible. Only one patient had more than 1 mm of open bite on long-term follow-up. An increase in overbite, resulting from incisor eruption, was noted in 14%, and an increase in overjet occurred in 12% as the mandible rotated. It appears that modest long-term skeletal and dental changes occur in some surgically treated long-face patients. The likelihood of long-term change was not related to the age of the patient, stability during the first postsurgical year, or segmentation of the maxilla at surgery.
Bailey
L J
LJ
Department of Orthodontics, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina 27599-7450.
Phillips
C
C
Proffit
W R
WR
Turvey
T A
TA
D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D005146:Facial Asymmetry / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D015588:Observer Variation; D010027:Osteotomy / Q000379:methods*; D012008:Recurrence; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014716:Vertical Dimension