Comparison of postoperative skeletal stability of maxillary segments after Le Fort I osteotomy, using patient-specific implant versus mini-plate fixation

• Published in: Journal of cranio-maxillo-facial surgery Vol. 47; no. 7; pp. 1020 - 1030
• Main Authors: Kotaniemi, Karoliina V.M., Heliövaara, Arja, Kotaniemi, Miika, Stoor, Patricia, Leikola, Junnu, Palotie, Tuula, Suojanen, Juho
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-07-2019
• Subjects: Bone Plates; Cephalometry; Dentistry; Humans; Le Fort I osteotomy; Maxilla - surgery; Orthognathic surgery; Osteotomy, Le Fort; Patient-specific implant; Relapse; Retrospective Studies; Stability; Orthognathic surgery; 3D; Relapse; Stability; Patient-specific implant; Le Fort I osteotomy
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2019.04.003

Three-dimensionally (3D) designed osteotomies and customised osteosynthesis are rapidly becoming standard in maxillofacial reconstructive and deformity surgery. Patient-specific implants (PSIs) have been in use for a few years in orthognathic surgery as well. In Le Fort I osteotomy, wafer-free fixation of the maxillary segment can be performed by individually manufactured cutting and drill guides together with PSIs.
This retrospective study was performed to compare the postoperative skeletal stability of the maxillary segment fixed by patient-specific implants versus mini-plates after Le Fort I osteotomy.
Fifty-one patients were divided into subgroups according to the fixation method and the advancement of the sub-spinal point. The postoperative skeletal stability of the maxillary segment was evaluated from lateral cephalometric radiographs one year postoperatively.
No statistically significant differences were found between the postoperative skeletal stability of the PSI and mini-plate fixed maxillae. Prospective studies, possibly with 3D fusion analysis, are warranted to confirm the results.
The choice between the two fixation methods does not seem to affect the postoperative skeletal stability of the maxillary segments.