title: Exact three-dimensional skull-related repositioning of the maxilla during orthognathic surgery.
abstract: The LeFort I osteotomy is standard for corrective repositioning of the maxilla, but intraoperative, skull-related, three-dimensional repositioning of the maxilla remains unsolved. Different ways of improving the accuracy of intraoperative, preoperatively planned, skull-related, correcting movements have been described, including the measurement of vertical maxillary shift, use of positioning devices (such as a face bow or a halo frame), and computer-assisted navigation. Nevertheless, intraoperative three-dimensional control of maxillary shift is not standard. Intraoperatively adjusted positioning pins define an exactly reproducible skull-related position for a reference splint. Skull-related repositioning of the maxilla after osteotomy can be done precisely in combination with two further splints, each allowing for different, well-defined repositioning of the reference splint in relation to the maxillary dental arch. The positioning device can be inserted using the standard intraoral approaches of the Le Fort I osteotomy. It does not result in further radiation exposure for the patient besides that usually necessary for preoperative planning. Three-dimensional imaging and expensive, computer-assisted navigational systems are not required. In contrast to previous procedures, the new device allows for intraoperative, three-dimensional, skull-related repositioning of the maxilla exactly according to the position planned preoperatively.
authors: Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital Aachen, Pauwelsstr. 30, 52070 Aachen, Germany. afueglein@ukaachen.de
authors: Alexander
authors: A
authors: Füglein
authors: Dieter
authors: D
authors: Riediger
mesh_terms: D002508:Cephalometry / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D008437:Maxilla / Q000601:surgery*; D057909:Orthognathic Surgery / Q000295:instrumentation* / Q000379:methods; D019340:Osteotomy, Le Fort / Q000295:instrumentation* / Q000379:methods