Stability of the Le Fort I osteotomy for maxillary advancement using rigid fixation and porous block hydroxyapatite grafting.
OBJECTIVE
The purpose of this study was to evaluate the stability of maxillary advancement using bone plates for skeletal stabilization and porous block hydroxyapatite (PBHA) as a bone graft substitute for interpositional grafting.


METHODS
The records of 78 patients (55 female, 23 male) with a diagnosis of anteroposterior maxillary hypoplasia were retrospectively evaluated. All patients underwent greater than 5 mm Le Fort I maxillary advancement with rigid fixation and PBHA interpositional grafting. The study sample was divided into 3 groups on the basis of the concurrent superior or inferior positioning of the maxillary incisors. Presurgery (T1), immediately postsurgery (T2), and longest follow-up (T3) lateral cephalometric tracings were superimposed to analyze for horizontal and vertical changes at the following landmarks: (1) point A, (2) incisal edge of the maxillary incisor, and (3) mesial cusp tip of maxillary first molar.


RESULTS
The maxilla was inferiorly repositioned in 27 patients, superiorly repositioned in 21 patients, and advanced horizontally without a significant vertical change in 30 patients. All groups showed 0.5 mm or less horizontal and vertical relapse. There was no statistically significant difference between the 3 groups.


CONCLUSIONS
Maxillary advancement with Le Fort 1 osteotomies by using rigid fixation and interpositional PBHA grafting is a stable and predictable procedure regardless of the direction of vertical maxillary movement.
Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A & M University System, Dallas, TX, USA.
Pushkar
P
Mehra
Vanessa
V
Castro
Rogerio Z
RZ
Freitas
Larry M
LM
Wolford
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D018786:Bone Substitutes; D017886:Durapatite; D005260:Female; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D019340:Osteotomy, Le Fort / Q000379:methods*; D012189:Retrospective Studies; D055502:Secondary Prevention; D014716:Vertical Dimension
D018786:Bone Substitutes; D017886:Durapatite