Ricard Daniel, Ferri Joël, Schlund Matthias
Department of Oral and maxillofacial surgery, Maxillo Montcalm clinic, Gatineau, Québec, Canada.
Department of Oral and maxillofacial surgery, Outaouais integrated health and social services center, McGill University affiliated hospital, Québec, Canada.
J Craniofac Surg. 2025;36(1):255-259. doi: 10.1097/SCS.0000000000010518. Epub 2024 Aug 27.
The aim of this study is to assess maxillary transverse dimension following presurgical maxillary segmented orthodontics associated with 3-piece Le Fort 1 osteotomy in a cohort of "long face syndrome" patients with palatal constriction.
Patients with maxillary transverse insufficiency were retrospectively included. They all underwent maxillary segmented orthodontics followed by a 3-piece Le Fort 1 osteotomy with palatal expansion. Palatal width dimensions were collected preoperatively, postoperatively, and at the time of the final follow-up, the stability of the expansion was analyzed.
Nineteen patients were included. There was no complication. The mean postoperative expansion was 6 mm (range: 3.1-8.7 mm) in the canine region and 4.3 mm (range: 0-9.1 mm) in the second molar region. The mean relapse was 0.36 mm (range: 0-1.4 mm) or 6% (range: 0%-16.1%) in the canine region and 0.17 mm (range: 0-1.3 mm) or 4% (range: 0%-14%) in the second molar region.
Presurgical maxillary segmented orthodontics with 3-piece Le Fort 1 osteotomy has shown high stability of the maxillary transverse dimension in a 1-step surgery without dental tipping. It should be considered as an alternative to rapid palatal expansion.
