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The International Journal of Adult Orthodontics & Orthogathic Surgery
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International Journal of Adult Orthodontics and Orthognathic Surgery

Year 1987
Volume 2 , Issue 2

Pages: 67 - 74

Skeletal stability after inferior maxillary repositioning


Biomechanical inefficiency and excessive stretch of the mandibular sling due to an increase in posterior maxillary height have been implicated as factors in vertical skeletal relapse occuring after inferior maxillary repositioning. The purpose of this investigation was to determine whether certain refinements in the design of the maxillary ostortomies would yeild acceptable clinical results. Ten consecutive patients with vertical maxillary deficiency were treated by Le Fort I osteotomy and autogenous interpositional bone grafting. The surgery was planned to increase lower anterior facial height while minimizing changes in posterior maxillary height. The maxillary osteotomies were designed to increase interfacing between the bone graft and host bone by positioning the lateral maxillary osteotomies as low inferiorly as was feasible in the anterior maxilla. Postsurgical stability was evaluated from cephalograms taken before and immediately after surgery, immediately after release of maxillomandibular fixation, and at 6 and 12 months postsurgically. Clinically acceptable results were achieved in this series of patients. However, further modification of the osteotomies might yield even better stability. Currently, the use of skeletal fixation along with modifications in lateral maxillary osteotomy design are being used to achieve these goals.


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