title: [Le Fort I osteotomies combined with post-operative bone grafts].
abstract: BACKGROUND
  We present and assess a surgical technique for maxillary auto-bone grafting concomitantly with Le Fort I osteotomy. The graft has 2 main objectives: to fill in the space between the 2 advanced segments of the maxilla to help bone consolidation, and to increase the volume of the malar, para-nasal spaces to improve post-operative esthetic results.
  
  
  METHODS
  Bone fragments, removed during the Le Fort I osteotomy, are stored and wrapped in a Surgicel(®) sheet, then grafted in the space left by the osteotomy, or on the anterior maxilla in the para-nasal area or on the malar bone. One hundred and twenty-three patient records, operated from 2007 to 2012, were collected to assess the post-operative course retrospectively. The post-operative course was uneventful in 93.5% of cases. About 8.4% of patients (7 cases) presented with a persistent post-operative maxillary edema. 1 patient (1.2%) presented with a sinus infection without any determined etiology. The grafts were all osteointegrated at the end of follow-up.
  
  
  CONCLUSIONS
  The technique is simple and quickly performed; it improves bone healing and cosmetic results, without increasing morbidity or surgical time. It is a good alternative to bone grafts from a secondary sample site. It can be applied to all Le Fort I osteotomies.
authors.affiliation: Clinique de chirurgie maxillo-faciale et stomatologie, CHU Hôtel-Dieu Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France. Electronic address: docteurguiol@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Guiol
authors.affiliation: Private practice 1900, University avenue, suite 101, E. Palo Alto, CA. États-Unis.
authors.forename: S A
authors.initials: SA
authors.lastname: Schendel
mesh_terms: D000328:Adult; D064592:Autografts; D016025:Bone Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery* / Q000637:transplantation; D019340:Osteotomy, Le Fort / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods; D055815:Young Adult
chemical_list: D002483:Cellulose, Oxidized; C013695:Surgicel
keywords: Bone grafting; Chirurgie orthognathique; Greffe osseuse; Le Fort I osteotomy; Orthognathic surgery; Ostéotomie de Le Fort I