Comparison study of the Le Fort I osteotomy using 2-and 4-plate fixation

This study was conducted to evaluate the postsurgical stability of Le Fort I osteotomy using zygomatic buttress internal fixation alone with no piriform aperture internal fixation. Patients with maxillary retrogna-thia and mandibular prognathism underwent the Le Fort I osteotomy with a bilateral sagittal split ramus osteotomy. In group I, fixation was accomplished using titanium plate and screws placed at the piriform aperture and the zygomatic buttress (4 plates). In group II, fixation was accomplished using titanium plate and screws placed at the zygomatic buttress (2 plates). Lateral cephalometric radiographs were taken preoperatively (T1), immediately after surgery (T2), and at 6 months to 1 year (T3) to evaluate skeletal movement. In total, 32 patients were included in this study. None of the patients had wound infection, dehiscence, bone fragment instability, and long-term malocclusion. Regarding point A and the posterior nasal spine (PNS), vertical and horizontal relapse in groups I and II did not differ significantly. In most hospitals, the maxilla was fixed using four plates (piriform aperture and zygomatic buttress); however, within the limitations of the study, the choice of the number of plates for osteosynthesis following Le Fort I osteotomy and repositioning of the maxilla can be left to the discretion of the surgeon without putting the patients at risk for increased relapse by careful intraoperative management.

Automated summary

This study evaluated the stability of Le Fort I osteotomy with zygomatic buttress internal fixation alone. Two groups of patients underwent the procedure, with group I receiving fixation at the piriform aperture and zygomatic buttress, and group II receiving fixation at the zygomatic buttress only. The results showed no significant differences in relapse between the groups, suggesting that the number of plates used for fixation can be determined by the surgeon without compromising outcomes.