Maxillary quadrangular Le Fort I osteotomy: long-term skeletal stability and clinical outcome

Abstract

The primary purpose of this study was to evaluate the long-term skeletal stability of the maxillary quadrangular Le Fort I osteotomy, and secondarily to determine patient overall experience and satisfaction with the surgical outcome. This retrospective cohort study evaluated a sample of patients with midface zygomatic-maxillary deficiency and Class III skeletal malocclusion. The primary outcome measure, on the basis of cephalometric analysis, was long-term vertical and horizontal skeletal stability in cleft and non-cleft patients, with and without interpositional autogenous iliac bone graft stabilization. A questionnaire measured patient overall experience and satisfaction with the surgery. One hundred twenty-one patients completed the questionnaire. Of these, 53 satisfied the cephalometric study inclusion criteria. Horizontal and vertical intraoperative movement and late postoperative movement showed overall high skeletal stability. No statistical difference in horizontal skeletal stability was noted between cleft and non-cleft patients, or between patients receiving or not receiving a bone graft. Mean satisfaction with the overall treatment result was 9.2 of 10 (10 being highest satisfaction). We conclude that the quadrangular Le Fort I osteotomy is a functionally stable and surgically predictable procedure for cleft and non-cleft patients with or without interpositional iliac bone graft, with a midfacial zygomatic-maxillary deficiency.

Keywords: cleft lip and palate deformity; iliac autogenous bone grafting; maxillary hypoplasia; maxillary osteotomy.