Le Fort III osteotomic variants

C. Ungari, A. Agrillo, V. Mitro, E. Riccardi, F. Cascino, D. Quarato, V. Pellacchia, P. Cascone, V. Ramieri, F. Filiaci

Department of Maxillo-Facial Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. emiliano.riccardi@hotmail.it

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• Surgery

INTRODUCTION: Midface hypoplasia is a skeletal defect involving all three space planes, hence needing a three-dimensional repositioning. This research study shows two cases of cranio-facial dysostosis, on which two Le Fort III variants were performed.

CASE REPORT: In the first case we report the performing the two types of osteotomy simultaneously. Le Fort I, however, has been performed without any pterygomaxillary disjunctions, thus accomplishing a complete midface mibilization without any variation of the occlusal ratios. In the second case a modified Le Fort III osteotomy has been performed with median disjunction; reduction of the transverse interdacryal diameters and of the pyriform opening.

DISCUSSION: Among all osteotomic variants we would like to mention the one introduced by Obwegeser in 1969 where, in patients with acceptable dental occlusal ratios, Le Fort III and Le Fort I have been performed in conjunction. This technique allows a different midface and dental occlusion repositioning.

CONCLUSIONS: In adult patients with permanent dentition and normal occlusal ratios – this technique may be chosen for a midface advancement without compromising the dento-skeletal relations, in order to achieve the best functional and aestetical results.

Published on: 2012/10/17

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