Stability of Le Fort I osteotomy with advancement: a comparison of single maxillary surgery and a two-jaw procedure.

PURPOSE

This study compared single maxillary surgery and a two-jaw procedure in patients who underwent one-piece Le Fort I advancement without bone grafting.

PATIENTS AND METHODS

Fifty-three patients had Le Fort I osteotomy performed using a standard technique. Twenty-two patients had maxillary surgery alone, and 31 patients additionally had a bilateral sagittal split ramus osteotomy performed. Both rigid and nonrigid fixation were used. The postoperative movement of the maxilla was investigated, comparing cephalograms taken preoperatively, 2 to 3 days postoperatively, and at least 6 months postoperatively. A computer program was used to superimpose the three radiographs.

RESULTS

No difference in postoperative stability was found when the two surgical procedures were compared, and no correlation between magnitude of advancement and degree of relapse could be identified (P > .05). Nonrigid fixation in patients receiving only maxillary surgery resulted in greater postoperative forward movement of the maxilla (P = .022).

CONCLUSION

This study indicates that postoperative stability of the maxilla in a two-jaw procedure is equivalent to that of single maxillary surgery. Nonrigid fixation in single maxillary surgery reduces the need for postoperative orthodontics.