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International Journal of Adult Orthodontics and Orthognathic Surgery

Year 1994
Volume 9 , Issue 3

Pages: 163 - 173

Stability following superior repositioning of the maxilla by Le Fort I osteotomy: Five- year follw-up


Changes in dental and skeletal relationships were evaluated 5 years postsurgically in 49 patients whose maxilla had been superiorly repositioned by a Le Fort I osteotomy. Aoo of the patients had at least 2 mm of intrusion at the maxillary incisor and molar; none had a mandibular ramus osteotomy or other osteotomy except genioplasty. Only 6.5% had 2 mm or greater of net vertical change in skeletal or dental landmarks at 1 year postsurgery. From 1 to 5 years post surgery, minimal changes in skeletal and dental landmarks occurred in the majority of the patients, but approximately 25% of the patients showed 2 mm or more of downward movement of the maxilla and/or eruption of maxillary teeth, leading to downward-backward rotation of the mandible. Only one patient had more than 1 mm of open bite on long-term follow-up. An increase in overbite, resulting from incisor eruption, was noted in 14%, and an incr ease in overjet occurred in 12% as the mandible rotated. It appears that modest long-term skeletal and dental changes occur in some surgically treated long-face patients. The likelihood of long-term change was not related to the age of the patient, stability during the first postsurgical year, or segmentation of the maxilla at surgery.


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