TY - JOUR
T1 - Stability of Le Fort I osteotomy with maxillary advancement. A comparison of combined wire fixation and rigid fixation
AU - Egbert, Mark
AU - Hepworth, Brad
AU - Myall, Robert
AU - West, Roger
N1 - Funding Information:
* Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA. "~ Dental student, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA. Professor, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA. § In private practice, Northwest Center for Corrective Jaw Surgery, Seattle, WA. Supported by NIDR grant #T35 DEO7150.
PY - 1995/3
Y1 - 1995/3
N2 - Purpose: This study compares two types of fixation: intraosseous wires, skeletal suspension wiring, and maxillomandibular fixation (combined wire fixation; CWF) with rigid internal fixation (RIF) in patients who underwent Le Fort I osteotomy to correct maxillary hypoplasia. Materials and Methods: All patients were operated on by the same surgeon using a standard technique, which included bone grafting. The 12 patients in group A were treated with CWF for 4 weeks. Group B was made up of 13 patients who had RIF and training elastics for 4 weeks. Cephalometric analysis using a commercial software package was performed on radiographs that were taken immediately preoperatively (T1), 1 day postoperatively (T2), and at least 1 year postoperatively (T4). The position of the maxilla in relation to the cranial base and Frankfort plane at each time interval was compared. Results: Postsurgical horizontal change (maxillary position change from T2 to T4) for both groups was in the posterior direction. In group A, six patients had less than 1 mm change, three had 1 to 2 mm change, and three had >2 mm change. In group B, 10 patients had less than 1 mm change, three had 1 to 2 mm change and 0 had >2 mm change. Comparison of mean values of groups A and B suggested improved stability with rigid versus wire fixation in the horizontal plane; however, statistical analysis of adjusted mean values showed no significant difference. Vertical changes in maxillary position were also measured from postoperatively to 1 year (T2 to T4). The vertical changes were minimal in those cases of maxillary advancement where no vertical changes were planned; however, there was a statistically significant (P = .0024) improved stability with RIF versus combined wire fixation cases. Comparison of adjusted means showed double the amount of vertical settling 1 year postoperatively in the CWF group. Conclusion:T> Overall, 22 of 25 patients with horizontal maxillary advancement had excellent stability at 1 year. Observed trends suggest that RIF may have improved stability over CWF.
AB - Purpose: This study compares two types of fixation: intraosseous wires, skeletal suspension wiring, and maxillomandibular fixation (combined wire fixation; CWF) with rigid internal fixation (RIF) in patients who underwent Le Fort I osteotomy to correct maxillary hypoplasia. Materials and Methods: All patients were operated on by the same surgeon using a standard technique, which included bone grafting. The 12 patients in group A were treated with CWF for 4 weeks. Group B was made up of 13 patients who had RIF and training elastics for 4 weeks. Cephalometric analysis using a commercial software package was performed on radiographs that were taken immediately preoperatively (T1), 1 day postoperatively (T2), and at least 1 year postoperatively (T4). The position of the maxilla in relation to the cranial base and Frankfort plane at each time interval was compared. Results: Postsurgical horizontal change (maxillary position change from T2 to T4) for both groups was in the posterior direction. In group A, six patients had less than 1 mm change, three had 1 to 2 mm change, and three had >2 mm change. In group B, 10 patients had less than 1 mm change, three had 1 to 2 mm change and 0 had >2 mm change. Comparison of mean values of groups A and B suggested improved stability with rigid versus wire fixation in the horizontal plane; however, statistical analysis of adjusted mean values showed no significant difference. Vertical changes in maxillary position were also measured from postoperatively to 1 year (T2 to T4). The vertical changes were minimal in those cases of maxillary advancement where no vertical changes were planned; however, there was a statistically significant (P = .0024) improved stability with RIF versus combined wire fixation cases. Comparison of adjusted means showed double the amount of vertical settling 1 year postoperatively in the CWF group. Conclusion:T> Overall, 22 of 25 patients with horizontal maxillary advancement had excellent stability at 1 year. Observed trends suggest that RIF may have improved stability over CWF.
UR - http://www.scopus.com/inward/record.url?scp=0028919553&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028919553&partnerID=8YFLogxK
U2 - 10.1016/0278-2391(95)90217-1
DO - 10.1016/0278-2391(95)90217-1
M3 - Article
C2 - 7861273
AN - SCOPUS:0028919553
SN - 0278-2391
VL - 53
SP - 243
EP - 248
JO - Journal of Oral and Maxillofacial Surgery
JF - Journal of Oral and Maxillofacial Surgery
IS - 3
ER -