Disgiunzione maxillare chirurgica: Osteotomia di Le Fort I multisegmentata

OBJECTIVES. The aim of this work was to evaluate the skeletal modifications obtained on transverse plane in adult patients, subjected to maxillary segmented Le Fort I osteotomy and sagittal mandibular osteotomy by Epker in the same surgical procedure, and to consider if the improvement provided to transverse diameters of the face was real and statistically significant. MATERIALS AND METHODS. 20 patients of both genders (8 females and 12 males) aged 22 to 47 years and showing a transverse maxillary hypoplasia, associated to alterations on sagittal and vertical plane, were analysed. A posteroanterior teleradiography before, after treatment and during a 6 months follow-up was prescribed to each patient. On these radiographs, cephalometric evaluations were performed, according to the Milan School guidelines. RESULTS. After treatment, the transverse dimensions of the maxilla and nasal cavity, the width of the upper and lower dental arch increased in all patients considered. Furthermore, the correction of the original dysmetrias and the recovery of dentofacial and skeletal symmetry were observed. CONCLUSIONS. Through segmented Le Fort I osteotomy, combined with mandibular osteotomy, it was possible to obtain a real and statistically significant improvement in the transverse diameter of the face, with the great advantage of solving both the maxillary and mandibular malocclusion in a single-phase surgery.