Comparison of the postsurgical stability of the Le Fort I osteotomy using 2- and 4-plate fixation.
OBJECTIVE
This study was conducted to evaluate the postoperative stability of Le Fort I osteotomies accomplished with 2-plate versus 4-plate fixation.


METHODS
This is a retrospective study involving 32 patients who underwent Le Fort I 1-piece osteotomy concurrent with orthodontic therapy. All patients were treated by 1 attending surgeon during an 18-month period. Sixteen patients were treated by plate and screw fixation consisting of 4 miniplates (group I), and an additional 16 patients were treated using 2 miniplates (group II). In group I, fixation was accomplished with 2.0-mm low-profile Lorenz (Walter Lorenz Surgical Inc, Jacksonville, FL) plates and screws placed at the piriform aperture and at the maxillary buttress. Four screws were placed in each of the plates. In group II, fixation was accomplished with 2.0-mm low-profile Lorenz plates and screws placed at the piriform aperture. Again, 4 screws were placed in each of the plates.


RESULTS
Serial cephalometric evaluation at arbitrary anterior nasal spine and posterior nasal spine for both groups showed that postoperative skeletal changes in the direction of the surgical movement were seen in approximately 20% of cases; these changes averaged less than 1 mm. Postoperative skeletal changes opposite to the direction of the surgical movement were seen in approximately 30% of cases; these changes also averaged less than 1 mm. No postoperative skeletal changes were seen in approximately 50% of cases. For all measured changes about arbitrary anterior nasal spine and posterior nasal spine, there was no significant difference between groups I and II.


CONCLUSIONS
This study suggested that postoperative skeletal changes associated with the use of 2-plate fixation do not appear to differ significantly from those seen with 4-plate fixation.
Indiana University School of Dentistry, Department of Oral Surgery and Hospital Dentistry, Indianapolis, IN, USA. rmurray@iupui.edu
R Anthony
RA
Murray
L George
LG
Upton
Keith R
KR
Rottman
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001860:Bone Plates; D001863:Bone Screws; D002508:Cephalometry; D004867:Equipment Design; D006801:Humans; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009295:Nasal Bone / Q000473:pathology; D009971:Orthodontics, Corrective; D019340:Osteotomy, Le Fort / Q000145:classification / Q000295:instrumentation*; D012189:Retrospective Studies; D013223:Statistics as Topic; D015050:Zygoma / Q000473:pathology / Q000601:surgery