Precise control of maxillary multidirectional movement in Le Fort I osteotomy using a surgical guiding device.
We introduced a surgical protocol to achieve accurate maxillary multidirectional movement in Le Fort I osteotomies. This comprised a way of controlling precision and a guiding device together with prebent titanium plates. We evaluated the protocol using a semiautomated 3-dimensional assessment in 22 patients with maxillary multidirectional movement (movement in three or more of six directions). Operations were all done between October 2015 and April 2017 by the same surgeon, who followed the protocol strictly. To evaluate the accuracy, we measured the deviation of the orientation of landmarks and of the upper dentition. All cases were followed up for at least a year. They all involved maxillary movement in at least three directions, and nine involved movement in six. The guiding device was used intraoperatively in all cases. Vertical deviation of the segments of bone was often detected during removal of bone, and sagittal deviation in three cases, but we found no transverse deviations. The assessment of accuracy showed that the mediolateral, anteroposterior, and superoinferior translations of landmarks were all less than 1mm, with mean values of 0.29, 0.43, and 0.39mm, respectively. The pitch, roll, and yaw of the upper dentition were also less than 1°, with mean values of 0.60°, 0.35°, 0.36°, respectively. The proposed protocol allowed accurate reposition of the maxilla with multidirectional movement during Le Fort I osteotomy.
['Xue|C|C|', 'Xu|H|H|', 'Tian|Y|Y|', 'Yang|X|X|', 'Luo|E|E|', 'Bai|D|D|']
D000293:Adolescent D000328:Adult D059925:Anatomic Landmarks D001696:Biomechanical Phenomena D001860:Bone Plates D002681:China D017076:Computer-Aided Design D005260:Female D006801:Humans D021621:Imaging, Three-Dimensional D008297:Male D008437:Maxilla D003765:Models, Dental D056948:Orthognathic Surgical Procedures D019340:Osteotomy, Le Fort D011446:Prospective Studies D014025:Titanium D014057:Tomography, X-Ray Computed
Le Fort I osteotomy Titanium plate CAD/CAM Orthognathic surgery