The surgical procedure is carried out as the standard model. The osteotomy fragment is displaced inferiorly and anteriorly, followed by rigid internal fixation. Inferior displacement http://en.wikipedia.org/wiki/Dicoumarol aids in solving the facial height discrepancy, and anterior displacement is required for sagittal discrepancy correction. Osteointegrated implants might be positioned simultaneously or at a 2nd stop by. Hereby, we propose a simplified surgical method with an immediate postoperative favourable effect and also a promising accomplishment charge. Our simplified surgical ways stick to. (1) Commence with transposition of the maxillary inferiorly and anteriorly right after Le Fort I osteotomy. (2) We emphasize the significance of attaining secure occlusion. (three) Then, we proceed with intermaxillary fixation. The distance of maxilla transportation demands to be planned preoperatively.
(4) Subsequent is rigid inner fixation on the dentoalveolar fragment working with a customized titanium plate preoperatively. (five) That has a tungsten bur, the nasal surface of your maxillary is regularized. (6) Bone grafting blocks are then positioned inside of the gap developed by the osteotomy in getting the http://en.wikipedia.org/wiki/Dicoumarol planned vertical height. (7) The bone grafting blocks are fixed in location working with a wire that goes beyond the graft and anchors on the custom-made plates (Figs. 1, ?,two).2). (eight) Last but not least, check out on the maxilla in its new place and new occlusion (Figs. 3, ?,four).4). The wire fixation of the grafts allows us to simplify the surgical step on the maxillary repositioning on top of that to making certain the stability of the bone grafts.
Figure 1 Fixation with the bone blocks http://en.wikipedia.org/wiki/Dicoumarol by using a wire that goes beyond the graft and anchors the plates. Figure 2 Sketch of fixation of your bone blocks having a wire that goes beyond the graft and anchors the plates. Figure three Impaction and fixation from the Le Fort I osteotomy being a conventional procedure. Screw the plates to the fixed maxillary fragment. Figure 4 Figure drawing in sagital see. Screw the plates on the fixed maxillary fragment and fixation of your bone block using a wire. At 1-year follow-up, the patient presented significant improvement with the vertical dimension of the facial middle third. Regarding the soft tissue cephalometry, the nasolabial angle changes from 60 to 90 degrees (lateral see) with an advancement in the subnasale level and relating to the soft tissue cephalometry, within the lateral see wherever the nasolabial angle modifications from 60 to 90 degrees with an advancement of your subnasale point. Within the frontal view, the younger visual appeal is due to the reduction on the nasolabial fold (Figs. five?566?677). Figure 5 (A) Preoperative frontal and lateral view. Recognize the remarkable maxillary atrophy as well as the lack of height of the facial middle third. (B) One-year follow-up. Figure six Tele-lateral radiograph.