Assessment of bone healing and hypoesthesia in the upper lip after Le Fort I osteotomy with self-setting α-tricalcium phosphate and absorbable plates

J Craniomaxillofac Surg. 2013 Mar;41(2):129-34. doi: 10.1016/j.jcms.2012.06.004. Epub 2012 Jul 20.

Abstract

Purpose: The purpose of this study was to evaluate hypoesthesia of the upper lip and bone formation using self-setting α-tricalcium phosphate (Biopex(®)) between the segments following Le Fort I osteotomy with bent absorbable plate fixation.

Subjects and methods: The subjects were 47 patients (94 sides) who underwent Le Fort I osteotomy with and without mandibular osteotomy. They were divided into a Biopex(®) group (48 sides) and a control group (46 sides). The Biopex(®) was inserted into the anterior part of the gap between the segments in the Biopex(®) group. Trigeminal nerve hypoesthesia at the region of the upper lip was assessed bilaterally by the trigeminal somatosensory-evoked potential (TSEP) method. The area of the Biopex(®) at the anterior part in the maxilla was assessed immediately after surgery and 1 year postoperatively by computed tomography (CT).

Results: The mean measurable period and standard deviation were 13.2 ± 18.5 weeks in the control group, 14.5 ± 17.9 weeks in the Biopex(®) group, and there was no significant difference in TSEP. The area of the Biopex(®) after 1 year was significantly smaller than that immediately after surgery (right side: P = 0.0024, left side: P = 0.0001) and bone defects between the segments could not be found in the Biopex(®) group. In the control group, although the areas of bone defect after 1 year were significantly smaller than that immediately after surgery on the right side (P = 0.0133) and left side (P = 0.0469) in the frontal view, complete healing of the bone defects could be seen in 12 of 46 sides after 1 year.

Conclusion: This study suggested that inserting Biopex(®) in the gap between the maxillary segments was useful for new bone formation and it did not prevent the recovery of upper lip hypoesthesia after Le Fort I osteotomy with absorbable plate fixation.

MeSH terms

  • Absorbable Implants*
  • Adolescent
  • Adult
  • Biocompatible Materials / therapeutic use*
  • Bone Plates*
  • Calcium Phosphates / therapeutic use*
  • Evoked Potentials, Somatosensory / physiology
  • Female
  • Follow-Up Studies
  • Humans
  • Hypesthesia / etiology*
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Lip Diseases / etiology*
  • Male
  • Mandibular Osteotomy / methods
  • Maxillary Osteotomy / methods*
  • Middle Aged
  • Orthognathic Surgical Procedures / methods
  • Osteogenesis / physiology
  • Osteotomy, Le Fort / methods*
  • Osteotomy, Sagittal Split Ramus / methods
  • Postoperative Complications*
  • Prognathism / surgery
  • Tomography, X-Ray Computed / methods
  • Trigeminal Nerve Diseases / etiology
  • Wound Healing / physiology
  • Young Adult

Substances

  • Biocompatible Materials
  • Calcium Phosphates
  • alpha-tricalcium phosphate