title: The influence of expansion on intraoperative bone blood flow in multisegmental maxillary osteotomies: an experimental study.
abstract: The aim of the presented study was to investigate the effect of maxillary expansion in multisegmental Le Fort I osteotomies on bone blood flow. Five sheep underwent a three-piece total maxillary osteotomy. Bone blood flow was measured intraoperatively by laser Doppler flowmetry in the premaxilla, the lateral segments and the mandible before osteotomy, after osteotomy and segmentation as well as after 4mm, 8mm and 12mm expansion with a Hyrax screw. A significant reduction in blood flow was seen after osteotomy and segmentation with a factor of 3.10 and between 4mm and 8mm expansion with a factor of 1.81. No significant differences could be found between 0mm and 4mm widening or between 8mm and 12mm widening. These results suggest that expansion of more than 4mm in multisegmental osteotomies enhances the risk of avascular sequelae. As greater maxillary widening has been carried out in many cases without avascular complications, further research on additional factors, influencing the recovery of perfusion, is needed.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Marienhospital Stuttgart, Germany. winfriedkretschmer@vinzenz.de <winfriedkretschmer@vinzenz.de>
authors.forename: W B
authors.initials: WB
authors.lastname: Kretschmer
authors.forename: G
authors.initials: G
authors.lastname: Baciut
authors.forename: C
authors.initials: C
authors.lastname: Dinu
authors.forename: M
authors.initials: M
authors.lastname: Baciut
authors.forename: I
authors.initials: I
authors.lastname: Barbur
authors.forename: A
authors.initials: A
authors.lastname: Muste
authors.forename: K
authors.initials: K
authors.lastname: Dietz
mesh_terms: D000818:Animals; D017078:Laser-Doppler Flowmetry; D054020:Lasers, Gas; D008334:Mandible / Q000098:blood supply; D008437:Maxilla / Q000098:blood supply / Q000601:surgery*; D016343:Monitoring, Intraoperative; D019340:Osteotomy, Le Fort / Q000145:classification / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation; D012039:Regional Blood Flow / Q000502:physiology; D012756:Sheep; D013997:Time Factors