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

Karoliina V M Kotaniemi; Arja Heliövaara; Miika Kotaniemi; Patricia Stoor; Junnu Leikola; Tuula Palotie; Juho Suojanen

doi:10.1016/j.jcms.2019.04.003

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

J Craniomaxillofac Surg. 2019 Jul;47(7):1020-1030. doi: 10.1016/j.jcms.2019.04.003. Epub 2019 Apr 27.

Authors

Karoliina V M Kotaniemi¹, Arja Heliövaara², Miika Kotaniemi³, Patricia Stoor⁴, Junnu Leikola², Tuula Palotie⁵, Juho Suojanen⁶

Affiliations

¹ Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital, Finland; Orthodontics, Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Finland. Electronic address: [email protected].
² Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital, Finland.
³ Department of Built Environment, Aalto University, Finland.
⁴ Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital, Finland.
⁵ Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital, Finland; Orthodontics, Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Finland.
⁶ Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital, Finland; Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillo-Facial Surgery, Lahti, Finland.

PMID: 31085061
DOI: 10.1016/j.jcms.2019.04.003

Abstract

Background: 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.

Aim: 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.

Patients: 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.

Results: 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.

Conclusion: The choice between the two fixation methods does not seem to affect the postoperative skeletal stability of the maxillary segments.

Keywords: 3D; Le Fort I osteotomy; Orthognathic surgery; Patient-specific implant; Relapse; Stability.

Publication types

Comparative Study

MeSH terms

Bone Plates
Cephalometry
Humans
Maxilla* / surgery
Osteotomy, Le Fort*
Retrospective Studies