STABILITY OF LE-FORT-I OSTEOTOMY WITH ADVANCEMENT - A COMPARISON OF SINGLE MAXILLARY SURGERY AND A 2-JAW PROCEDURE

Purpose: This study compared single maxillary surgery and a two-jaw pr ocedure in patients who underwent one-piece Le Fort I advancement with out bone grafting. Patients and Methods: Fifty-three patients had Le F ort I osteotomy performed using a standard technique. Twenty-two patie nts had maxillary surgery alone, and 31 patients additionally had a bi lateral sagittal split ramus osteotomy performed. Both rigid and nonri gid 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 pr ogram was used to superimpose the three radiographs. Results: No diffe rence in postoperative stability was found when the two surgical proce dures were compared, and no correlation between magnitude of advanceme nt and degree of relapse could be identified (P >.05). Nonrigid fixati on in patients receiving only maxillary surgery resulted in greater po stoperative forward movement of the maxilla (P = .022). Conclusion: Th is study indicates that postoperative stability of the maxilla in a tw o-jaw procedure is equivalent to that of single maxillary surgery. Non rigid fixation in single maxillary surgery reduces the need for postop erative orthodontics.