Three-year stability of open-bite correction by 1-piece maxillary osteotomy

Am J Orthod Dentofacial Orthop. 2008 Jul;134(1):60-6. doi: 10.1016/j.ajodo.2006.05.049.

Abstract

Introduction: The purpose of this retrospective cephalometric study was to evaluate the long-term vertical stability of anterior open-bite correction by 1-piece Le Fort I osteotomy and rigid fixation.

Methods: The sample comprised 40 consecutively treated patients from the files of the Department of Orthodontics, University of Oslo, Norway. All subjects had received a 1-piece Le Fort I osteotomy as the only surgical procedure from 1990 through 1998 and were followed for 3 years according to a protocol for data collection. Lateral cephalograms were obtained before surgery and at 5 occasions after surgery.

Results: The mean open bite before surgery was 2.6 mm; at the 3-year follow-up, 35 patients had a positive overbite, and the remaining 5 patients had an open bite between 0.2 and 0.9 mm. Impaction of the posterior maxilla >or=2 mm relapsed on average by 31%, and inferior repositioning of the anterior maxilla >or=2 mm relapsed by 62%. Maxillary vertical skeletal changes during the postsurgery period were compensated for by orthodontic dentoalveolar adaptation. Most of the skeletal relapse occurred during the first 6 months after surgery and always in the direction opposite to the surgical movement. The relative contribution of mandibular and maxillary changes in anterior open-bite closure was approximately 3:1.

Conclusions: Surgical correction of anterior open bite was generally stable over a 3-year period, and skeletal relapse was counteracted by dentoalveolar compensation.

MeSH terms

  • Adolescent
  • Adult
  • Alveolar Process / pathology
  • Bone Plates
  • Cephalometry
  • Chin / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Incisor / pathology
  • Longitudinal Studies
  • Male
  • Mandible / pathology
  • Maxilla / pathology
  • Maxilla / surgery*
  • Middle Aged
  • Nasal Bone / pathology
  • Open Bite / pathology
  • Open Bite / surgery*
  • Osteotomy, Le Fort / instrumentation
  • Osteotomy, Le Fort / methods*
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Vertical Dimension