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Le fort 1 Osteotomy

Jop P Verweij, Gert J M Hassing, Marta Fiocco, Pascal N W J Houppermans, J P Richard van Merkesteyn
The aim of this study was to analyse the incidence of removal of MESH plates because of symptoms after Le Fort I osteotomy (LF1). The medical files of patients treated with LF1 were retrospectively reviewed. The occurrence of MESH plate removal, indication for removal and time between insertion and removal were noted. The medical literature was reviewed to quantify the reported incidences of removal of titanium osteosynthesis material after LF1. A total of 158 patients were included in this study. LF1 was performed and fixed with MESH plates in 150 patients...
September 23, 2016: Journal of Cranio-maxillo-facial Surgery
Jeffrey C Posnick, Elbert Choi, Anish Chavda
PURPOSE: Frequency estimates of surgical site infection (SSI) after orthognathic surgery vary considerably. The purpose of this study was to determine the incidence and site of SSIs and associated risk factors after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery. MATERIALS AND METHODS: The authors executed a retrospective cohort study of patients with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing...
September 20, 2016: Journal of Oral and Maxillofacial Surgery
Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros
BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia...
September 30, 2016: Cochrane Database of Systematic Reviews
Yunfeng Li, Zhiai Hu, Bin Ye, Yao Liu, Xiaochun Ren, Songsong Zhu
PURPOSE: Orthognathic surgery is an efficient procedure for cosmetic and functional aims. However, when functional improvement is achieved by mandibular or maxillary operations, additional esthetic corrections may be imperative for some patients. This study aims to introduce our primary practice of simultaneous facial bone contouring and orthognathic surgery for esthetic reasons. PATIENTS AND METHODS: Ten patients with dentofacial deformities as well as a prominent angle, asymmetric deformities, or a high zygoma and zygomatic arch were recruited from West China Hospital of Stomatology, Sichuan University (Chengdu, China), between January 1, 2014, and July 31, 2015...
August 31, 2016: Journal of Oral and Maxillofacial Surgery
Jeffrey C Posnick, Jorge Perez, Anish Chavda
PURPOSE: The purpose of this study was to assess for the maintenance of a corrected occlusion and ongoing mandibular growth in a group of patients younger than 26 years with hemimandibular elongation (HME) who underwent bimaxillary orthognathic reconstruction. MATERIALS AND METHODS: We conducted a retrospective cohort study of HME patients operated on by a single surgeon at 1 institution between 1999 and 2013. At a minimum, all patients underwent Le Fort I and bilateral sagittal ramus osteotomies...
August 24, 2016: Journal of Oral and Maxillofacial Surgery
Christopher R DeSesa, Philip Metzler, Rajendra Sawh-Martinez, Derek M Steinbacher
BACKGROUND: Le Fort I osteotomy imparts significant changes to the nasolabial region. Past studies have relied on 2-dimensional data and have not delineated differences among various Le Fort I subtypes. The purpose of this study is to 3-dimensionally analyze Le Fort I-induced nasal and lip changes comparing advancement alone versus widening alone [surgically assisted maxillary expansion (SAME)] versus advancement and widening. We hypothesize that the combination of maxillary advancement with widening will result in the most profound changes...
August 2016: Plastic and Reconstructive Surgery. Global Open
Siamak Hemmatpour, Fatemeh Kadkhodaei Oliadarani, Ali Hasani, Vahid Rakhshan
INTRODUCTION: The aim of this before-after clinical trial was to evaluate nasolabial soft tissue changes in the frontal plane after bimaxillary surgery. METHODS: A total of 20 skeletal Class III Iranian patients needing bimaxillary Le Fort I osteotomy plus mandibular setback surgery were enrolled in this trial. Patients underwent 4.02 ± 1.02 mm of maxillary advancement (Le Fort I osteotomy, 4.33 ± 1.21 mm in men, 3.81 ± 0.86 mm in women) and 7.13 ± 1...
August 31, 2016: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
J Kraeima, J Jansma, R H Schepers
To analyse the accuracy of maxillary positioning after Le Fort I osteotomy, we retrospectively assessed the outcome in three patients (mean (range) age 40 (21 - 60) years) who had been treated with patient-specific CAD-CAM osteosynthesis plates as part of a bimaxillary osteotomy. Virtual surgical planning in each case was based on cone-beam computed tomography (CT) (Simplant® O&O, Dentsply Implants NV, Kessel-Lo, Belgium), and patient-specific CAD-CAM drilling guides and osteosynthesis plates were produced for maxillary positioning and fixation...
August 13, 2016: British Journal of Oral & Maxillofacial Surgery
Altan Varol, Onur Atali, Aysegul Sipahi, Selcuk Basa
PURPOSE: The aim of this 4-year retrospective follow-up study was to investigate treatment outcomes, including implant survival rate and marginal bone loss, in patients with maxillary Cawood type VI atrophy pattern who underwent Le Fort I downgrafting and iliac block augmentations for implant rehabilitation. MATERIALS AND METHODS: Retrognathic edentulous Class III patients with severe maxillary resorption (Cawood VI) were enrolled. Reconstructive procedures performed included Le Fort I maxillary osteotomy, iliac block grafting, labial sulcoplasties, and dental implant placement...
August 15, 2016: International Journal of Oral & Maxillofacial Implants
Arif Razzak, Nabeela Ahmed, Andrew Sidebottom
Costochondral grafts are used to replace the mandibular condyle in cases of TMJ ankylosis, and are generally viewed as a gold standard for autogenous reconstruction of the mandibular condyle (Güven, 2000; Posnick and Goldstein, 1993 [1,2]). We report a case where overgrowth of costochondral grafts is seen, resulting in asymmetric mandibular growth and dentofacial asymmetry (Posnick and Goldstein, 1993 [2]). A 17 year old male patient presented with an existing costochondral graft performed due to TMJ ankylosis during childhood...
2016: International Journal of Surgery Case Reports
Soma Kita, Marie Oshima, Kazuo Shimazaki, Toshinori Iwai, Susumu Omura, Takashi Ono
PURPOSE: This study aimed to evaluate the influence of maxillary impaction orthognathic surgery on nasal respiratory function and the efficacy of bone trimming at the inferior edge of the pyriform aperture. MATERIALS AND METHODS: The participants were 10 patients (3 male and 7 female patients) with mandibular prognathism who underwent bimaxillary orthognathic surgery with maxillary impaction. The surgical procedures performed were Le Fort I osteotomy with bone trimming at the inferior edge of the pyriform aperture and bilateral sagittal split osteotomy...
June 21, 2016: Journal of Oral and Maxillofacial Surgery
Akinori Moroi, Kunio Yoshizawa, Takamitsu Tsutsui, Yuriko Saida, Asami Hotta, Kenichi Fukaya, Ryota Hiraide, Akihiro Takayama, Tatsuya Tunoda, Yuuki Saito, Koichiro Ueki
The purpose of this study was to evaluate the effects of Le Fort I osteotomy on nasal septum deviation and differences in left and right airway sizes, and to determine whether the nasal septum was affected by differences in the direction of movement. Forty patients underwent conventional Le Fort I osteotomy, and computed tomography (CT) was performed preoperatively, and 1 week and 1 year postoperatively. The nasal septum angle and airway area were measured at the anterior, middle, and posterior positions on the CT images Patients were divided into 2 groups depending on each difference in movement (impaction ≥5 mm or other; anterior movement or other; and impaction asymmetry or other)...
September 2016: Journal of Cranio-maxillo-facial Surgery
C Y Yen, C L Kuo, I H Liu, W C Su, H R Jiang, I G Huang, S Y Liu, S Y Lee
Classic cinch suture narrowing of the nasal alar base by medially suturing the bilateral nasolabial soft tissue with one long suture has a limited effect. The modified cinch method described in the present study anchors non-absorbable sutures to the bilateral lower border of the piriform rim and provides optimal direction, position, and stability. The sutures can be shortened and the strength kept stable while the surgical wounds heal. Separate bilateral sutures can also reduce interference and distortion from nasotracheal intubation and make the nasolabial profile more symmetrical...
June 27, 2016: International Journal of Oral and Maxillofacial Surgery
Ko Dezawa, Noboru Noma, Kosuke Watanabe, Yuka Sato, Ryutaro Kohashi, Morio Tonogi, Gary Heir, Eli Eliav, Yoshiki Imamura
We examined the short-term surgical effects of orthognathic surgery on somatosensory function. Observations were made over a short period: 3 months postoperatively. In total, 14 patients and 32 healthy controls participated. Among the 14 patients, one underwent bilateral sagittal split osteotomy alone and 13 underwent bilateral sagittal split osteotomy in combination with a Le Fort I osteotomy. A modified quantitative sensory testing (QST) protocol (the German Research Network on Neuropathic Pain, DFNS) was used to evaluate clinically the skin of the chin for sensory disturbances before surgery and at 1 week, 1 month, and 3 months postoperatively...
2016: Journal of Oral Science
Vinisha Ranna, Sergio Varela Kellesarian, Changyong Feng, Fawad Javed, Alexis Ghanem
OBJECTIVE: Abnormalities of the midface and maxilla are frequently corrected using Le Fort I surgery. This osteotomy passes near the apices of the maxillary teeth, severing the blood vessels and nerves supplying the teeth. The aim of this review was to determine the effect of Le Fort I osteotomy on pulpal vascularity and neurosensory response. DATA SOURCES: A systematic search of the literature was performed in PubMed/ Medline, Google Scholar, EMBASE, and ISI Web of Knowledge from 1969 up to and including December 2015 using the following key words: Le Fort 1, tooth vitality, maxillary osteotomy, pulp, orthognathic...
2016: Quintessence International
A Almukhtar, A Ayoub, B Khambay, J McDonald, X Ju
We describe the comprehensive 3-dimensional analysis of facial changes after Le Fort I osteotomy and introduce a new tool for anthropometric analysis of the face. We studied the cone-beam computed tomograms of 33 patients taken one month before and 6-12 months after Le Fort I maxillary advancement with or without posterior vertical impaction. Use of a generic facial mesh for dense correspondence analysis of changes in the soft tissue showed a mean (SD) anteroposterior advancement of the maxilla of 5.9 (1.7) mm, and mean (SD) minimal anterior and posterior vertical maxillary impaction of 0...
September 2016: British Journal of Oral & Maxillofacial Surgery
Y Wu, Z L Li, X Wang, B Yi, L Ma
OBJECTIVE: To evaluate the surgical corrective results of maxillary hypoplasia in patients with cleft lip and palate withtranspalatal modified Le Fort I osteotomy. METHODS: In the study, 11 patients (4 women, and 7 men) with maxillary hypoplasia secondary to cleft lip and palate underwent transpalatal modified Le Fort I osteotomy at Peking University School of Stomatology from Jan. 2012 to Dec. 2013,with the mean age of 21 years ( from 18 to 27 years), Bilateral sagittal split ramus osteotomy (BSSRO)and genioplasty were performed simultaneously in 9 of them for better appearance and functional occlusion...
June 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
K Andersen, M Thastum, S E Nørholt, J Blomlöf
The aim of this study was to investigate the length of stay (LOS) following orthognathic surgery and thereby to establish a benchmark. The secondary aim was to identify predictors of postoperative LOS following orthognathic surgery. Patients were treated consecutively during the period 2010 to 2012. Inclusion criteria were (1) patient age ≥18 years, and (2) surgery involving a three-piece Le Fort I osteotomy, or a bilateral sagittal split osteotomy (BSSO), or bimaxillary surgery. A total of 335 patients were included...
October 2016: International Journal of Oral and Maxillofacial Surgery
Jonathan P Massie, Christopher M Runyan, Marleigh J Stern, Michael Alperovich, Scott M Rickert, Pradip R Shetye, David A Staffenberg, Roberto L Flores
IMPORTANCE: Septal deviation commonly occurs in patients with cleft lip and palate (CLP); however, the contribution of the cartilaginous and bony septum to airway obstruction in skeletally mature patients is poorly understood. OBJECTIVES: To describe the internal nasal airway anatomy of skeletally mature patients with CLP and to determine the contributors to airway obstruction. DESIGN, SETTING, AND PARTICIPANTS: This single-center retrospective review included patients undergoing cone-beam computed tomography (CBCT) from November 1, 2011, to July 6, 2015, at the cleft lip and palate division of a major academic tertiary referral center...
September 1, 2016: JAMA Facial Plastic Surgery
Rivka Bendrihem, Christian Vacher
PURPOSE: In Le Fort 1 osteotomies there is a risk of injuring the maxillary artery, during the pterygomaxillary (PM) disjunction. To improve the knowledge of the relation between the maxillary artery and the PM suture, an anatomic study of the pterygopalatal fossa has been performed. METHODS: The study was based on CT scan head with vascular injection of the supraaortic trunks in 92 patients. The vertical length of the PM junction and the position of maxillary artery in relation to PM junction have been measured on a parasagittal plane passing through the lateral surface of the PM junction, and on a plane where the PM suture is the highest...
May 18, 2016: Surgical and Radiologic Anatomy: SRA
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