Anterior open bite correction by Le Fort I osteotomy with or without anterior segmentation: which is more stable?

• Published in: International journal of oral and maxillofacial surgery Vol. 46; no. 6; pp. 766 - 773
• Main Authors: Ismail, I.N, Leung, Y.Y
• Format: Journal Article
• Language: English
• Published: Denmark Elsevier Ltd 01.06.2017
• Subjects: anterior open bite; anterior segmentation; cephalometric analysis; Cephalometry; Dentistry; Female; Humans; Le Fort I osteotomy; Male; maxillary surgery; Open Bite - surgery; Osteotomy, Le Fort; Recurrence; Retrospective Studies; Risk Factors; Surgery; Treatment Outcome; Young Adult; anterior open bite; cephalometric analysis; anterior segmentation; Le Fort I osteotomy; maxillary surgery
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2017.02.1275

Abstract A retrospective cohort study was conducted to analyze the relapse rate of anterior open bite (AOB) correction comparing Le Fort I osteotomy with and without anterior segmentation. The risk factors that might contribute to relapse were also assessed. Lateral cephalograms obtained at six different times were analyzed. A total of 81 patients with AOB were recruited. Thirty-five patients underwent Le Fort I osteotomy without anterior segmentation and 46 patients underwent anterior segmentation. Le Fort I osteotomy with anterior segmentation resulted in significantly more AOB relapse when compared to that without anterior segmentation at 7 weeks postoperative (15.2% vs. 0%, P = 0.016). During the early postoperative period, factors that contributed to AOB relapse in Le Fort I osteotomy with anterior segmentation were AOB closure ≥4 mm and inferior positioning of the anterior segment >2 mm. Over the long term, AOB closure ≥4 mm and intraoral vertical ramus osteotomy as the only mandibular procedure were factors identified as causing more AOB relapse in those treated by Le Fort I osteotomy with anterior segmentation. In conclusion, Le Fort I osteotomy without anterior segmentation was found to be more stable in the surgical correction of AOB in the early and late postoperative periods.