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Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint.

Blæhr TL, Jensen T, Due KM, Neumann-Jensen B - J Oral Maxillofac Res (2014)

Bottom Line: Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm) and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm).The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5°) (95% CI: -1.83 to 1.69°).There was no statistically significant difference in stability between the two groups at the P value 0.05.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg Denmark.

ABSTRACT

Objectives: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint.

Material and methods: 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral cephalometric radiographs.

Group a: The upper incisor had a mean intrusion of -0.56 mm (SD 0.77; range -2.04 to 1.08 mm) and a mean posterior movement of -0.93 mm (SD 1.03; range -2.52 to 0.96 mm). The mean change in the axial inclination of the upper incisor was -0.33° (SD 2.56; range -6° to 4°) (95% CI: -1.75 to 1.08°). Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm) and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm). The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5°) (95% CI: -1.83 to 1.69°). There was no statistically significant difference in stability between the two groups at the P value 0.05.

Conclusions: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment in segmental Le Fort I osteotomy.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photographs, showing skeletal wires fixed at the symphysis (A) and at the anterior nasal spine (B).
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fig1: Intraoperative photographs, showing skeletal wires fixed at the symphysis (A) and at the anterior nasal spine (B).

Mentions: Surgery was performed under general anaesthesia with nasotracheal intubation. The segmental Le Fort I osteotomies were performed as described by Bell [8] with vertical interdental osteotomies mesial to the canines connected to a U-shaped osteotomy in the palate. After mobilization of the segments the occlusal splint was ligated to the teeth in the maxilla with 0.4 mm wires. In all patients IMF was applied using 0.4 mm wires and elastics. After verifying the new position of the maxilla in all three dimensions, the maxilla was stabilized with L-shaped 1.7 mm titanium plates (Stryker Leibinger, Freiburg, Germany) at the zygomatic buttresses, the anterior aspect of the maxilla and at the pyriform aperture. A total of six plates were placed, three on each side. IMF was released and the occlusion in the splint was checked. An additional horizontal incision was made in the inferior alveololabial sulcus to expose the mental symphysis. All patients had skeletal wire fixation 0.6 mm secured at the anterior nasal spine and at the mental symphysis (Figure 1). The wires were bent to facilitate the application of skeletal elastic fixation postoperatively. The mucosa was sutured with resorbable 4-0 Vicryl. The peroperative fixed occlusal splint was either maintained for 6 weeks postoperatively (group A) or removed immediately after surgery (group B). The decision to maintain the splint or remove it was made by the operating surgeon.


Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint.

Blæhr TL, Jensen T, Due KM, Neumann-Jensen B - J Oral Maxillofac Res (2014)

Intraoperative photographs, showing skeletal wires fixed at the symphysis (A) and at the anterior nasal spine (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4219863&req=5

fig1: Intraoperative photographs, showing skeletal wires fixed at the symphysis (A) and at the anterior nasal spine (B).
Mentions: Surgery was performed under general anaesthesia with nasotracheal intubation. The segmental Le Fort I osteotomies were performed as described by Bell [8] with vertical interdental osteotomies mesial to the canines connected to a U-shaped osteotomy in the palate. After mobilization of the segments the occlusal splint was ligated to the teeth in the maxilla with 0.4 mm wires. In all patients IMF was applied using 0.4 mm wires and elastics. After verifying the new position of the maxilla in all three dimensions, the maxilla was stabilized with L-shaped 1.7 mm titanium plates (Stryker Leibinger, Freiburg, Germany) at the zygomatic buttresses, the anterior aspect of the maxilla and at the pyriform aperture. A total of six plates were placed, three on each side. IMF was released and the occlusion in the splint was checked. An additional horizontal incision was made in the inferior alveololabial sulcus to expose the mental symphysis. All patients had skeletal wire fixation 0.6 mm secured at the anterior nasal spine and at the mental symphysis (Figure 1). The wires were bent to facilitate the application of skeletal elastic fixation postoperatively. The mucosa was sutured with resorbable 4-0 Vicryl. The peroperative fixed occlusal splint was either maintained for 6 weeks postoperatively (group A) or removed immediately after surgery (group B). The decision to maintain the splint or remove it was made by the operating surgeon.

Bottom Line: Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm) and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm).The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5°) (95% CI: -1.83 to 1.69°).There was no statistically significant difference in stability between the two groups at the P value 0.05.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg Denmark.

ABSTRACT

Objectives: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint.

Material and methods: 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral cephalometric radiographs.

Group a: The upper incisor had a mean intrusion of -0.56 mm (SD 0.77; range -2.04 to 1.08 mm) and a mean posterior movement of -0.93 mm (SD 1.03; range -2.52 to 0.96 mm). The mean change in the axial inclination of the upper incisor was -0.33° (SD 2.56; range -6° to 4°) (95% CI: -1.75 to 1.08°). Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm) and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm). The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5°) (95% CI: -1.83 to 1.69°). There was no statistically significant difference in stability between the two groups at the P value 0.05.

Conclusions: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment in segmental Le Fort I osteotomy.

No MeSH data available.


Related in: MedlinePlus