The surgical procedure is performed since the conventional model. The osteotomy fragment is displaced inferiorly and anteriorly, followed by rigid inner 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 placed simultaneously or at a second stop by. Hereby, we propose a simplified surgical technique with an instant postoperative constructive impact and a promising achievement rate. Our simplified surgical actions follow. (one) Begin with transposition with the maxillary inferiorly and anteriorly immediately after Le Fort I osteotomy. (2) We emphasize the significance of achieving steady occlusion. (3) Then, we proceed with intermaxillary fixation. The distance of maxilla transportation needs to become planned preoperatively.
(four) Subsequent is rigid internal fixation of the dentoalveolar fragment using a personalized titanium plate preoperatively. (five) Which has a tungsten bur, the nasal surface on the maxillary is regularized. (six) Bone grafting blocks are then placed inside of the gap produced from the osteotomy in obtaining the http://en.wikipedia.org/wiki/Dicoumarol planned vertical height. (7) The bone grafting blocks are fixed in place making use of a wire that goes beyond the graft and anchors to your custom-made plates (Figs. one, ?,two).two). (eight) Finally, verify within the maxilla in its new place and new occlusion (Figs. three, ?,four).4). The wire fixation of the grafts makes it possible for us to simplify the surgical phase on the maxillary repositioning also to ensuring the stability from the bone grafts.
Figure 1 Fixation on the bone blocks http://en.wikipedia.org/wiki/Dicoumarol by using a wire that goes past the graft and anchors the plates. Figure two Sketch of fixation on the bone blocks having a wire that goes beyond the graft and anchors the plates. Figure 3 Impaction and fixation of your Le Fort I osteotomy as being a conventional process. Screw the plates for the fixed maxillary fragment. Figure four Figure drawing in sagital view. Screw the plates to your fixed maxillary fragment and fixation in the bone block with a wire. At 1-year follow-up, the patient presented significant improvement on the vertical dimension in the facial middle third. Pertaining to the soft tissue cephalometry, the nasolabial angle alterations from 60 to 90 degrees (lateral view) with an advancement with the subnasale level and relating to the soft tissue cephalometry, while in the lateral view where the nasolabial angle alterations from 60 to 90 degrees with an advancement of the subnasale point. While in the frontal view, the younger physical appearance is due to the reduction in the nasolabial fold (Figs. five?566?677). Figure five (A) Preoperative frontal and lateral see. Discover the amazing maxillary atrophy plus the lack of height from the facial middle third. (B) One-year follow-up. Figure six Tele-lateral radiograph.