Anatomic basis of Le Fort 1 impaction osteotomy: a radiological study

Surgical and Radiologic Anatomy : SRA
Rivka BendrihemJean-Pierre Pelage

Abstract

In Le Fort 1 osteotomy when a maxillary impaction is necessary, surgeons have to face different anatomical problems. (1) To determine the best bone resection route, they have to consider the situation of dental roots, infraorbital foramen and maxillary artery. (2) In case of Le Fort 1 osteotomy combined with a mandibular sagittal split osteotomy, the palate has to be replaced in horizontal position although there is no anatomical landmark. (3) In case of Gummy smiles, it can be due to either long face or short upper lip. The main objective was to identify safe bony landmarks to perform a Le Fort I osteotomy and to find a reliable way for repositioning the palate horizontally; the secondary objective was to determine the upper lip normal length. The study was based on 178 facial CT examinations. The following parameters have been used: the vertical length of the upper lip, the vertical heights of the anterior nasal spine, the canine and molar roots, the inferior limit of the pterygomaxillary fossa and the vertical height of the infraorbital foramen on both sides. The vertical length from the subnasal point to the upper vermilion was 15.06 ± 3.09 mm, and to the junction of the upper and lower lips was 23.94 ± 3.79 mm. The vertica...Continue Reading

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