• 대한치과교정학회지
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• 제40권6호
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• pp.383-397
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• 2010

본 연구는 상순돌출을 동반한 골격성 III급 부정교합에서 전방분절골절단술(anterior segmental osteotomy, ASO)을 병용한 상행지시상분할골절단술(bilateral sagittal split ramus osteotomy, BSSRO)과 Le Fort I 골절 단술을 병용한 상행지시상분할골절단술(BSSRO) 후 상악의 경 연조직 변화 및 경조직 변화에 대한 연조직 변화율을 비교하였다. A군은 ASO/BSSRO를 시행한 군 14명, B군은 Le Fort I/BSSRO를 시행한 환자 중 상악의 후방부가 상방으로 이동(posterior impaction)된 15명으로 구성되었다. 수술 전 2개월 이내와 수술 후 6개월 이후에 촬영한 측모두부방사선사진을 분석하여 다음과 같은 결과를 얻었다. 두 군 모두 수술 후 상악 전방부 경조직과 연조직이 후방이동되었고, A군에서 더 큰 변화량을 보였다. A point의 후방이동에 따른 superior labial sulcus의 변화율은 A군에서 79%, B군에서 15%를 보였고, supradentale에 대해 labrale superious는 A군에서 80%, B군에서 68%의 비율로 후방이동하였다. 교합평면각은 B군에서 증가한 반면, A군에서는 통계적으로 유의성 있는 변화가 없었다. 이상의 연구결과 골격성 III급 부정교합의 양악수술 시 상악 수술은 상악 전방부와 상순의 돌출이 심한 경우에는 ASO를 시행하고 교합평면각의 증가가 필요한 경우에는 posterior impaction을 동반한 Le Fort I 골절단술을 시행하는 것이 바람직하다.

• 대한두개안면성형외과학회지
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• 제18권1호
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• pp.5-8
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• 2017

Among the classification of maxillary fracture, the Le Fort classification is the best-known categorization. Le Fort (1901) completed experiments that determined the maxilla areas of structural weakness which he designated as the "lines of weakness". According to these results, there are three basic fracture line patterns (transverse, pyramidal and craniofacial disjunction). A transverse fracture is a Le Fort I fracture that is above the level of the apices of the maxillary teeth section, including the entire alveolar process of the maxilla, vault of the palate and inferior ends of the pterygoid processes in a single block from the upper craniofacial skeleton. Le Fort fractures result in both a cosmetic and a functional deficit if treated inappropriately. In this article, authors review the management of a Le Fort I fracture with a case-based discussion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권1호
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• pp.1-4
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• 2000

저자 등은 경희대학교 구강악안면외과에 내원한 중안면성장 부전을 동반한 하악전돌증 환자의 치료에 있어 관상절개를 통한 Le Fort III 골절단술 및 Le Fort I 골절단술과 양측 하악지시상분 할골절단술을 2회법으로 시행하여 기능적 심미적으로 만족할만한 결과를 얻었기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.32.1-32.4
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• 2020

Background: Le Fort I osteotomy is a highly effective treatment for skeletal jaw deformities and is commonly performed. High Le Fort I osteotomy is a modified surgical procedure performed for improving the depression of the cheeks by setting the osteotomy higher than the conventional Le Fort I osteotomy. Developments in three-dimensional (3D) technology have popularized the use of 3D printers in various institutions, especially in orthognathic surgeries. In this study, we report a safe and inexpensive method of performing a high Le Fort I osteotomy using a novel 3D device and piezosurgery, which prevent tooth root injury without disturbing the operation field for patients with a short midface and long tooth roots. Results: A 17-year-old woman presented with facial asymmetry, mandibular protrusion, a short midface, and long tooth roots. We planned high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. Prevention of damage to the roots of the teeth and the infraorbital nerve and accurate determination of the posterior osteotomy line were crucial for clinical success. Le Fort I osteotomy using 3D devices has been reported previously but were particularly large in size for this case. Additionally, setting the fixing screw of the device was difficult, because of the risk of damage to the roots of the teeth. Therefore, a different surgical technique, other than the conventional Le Fort I osteotomy and 3D device, was required. The left and right parts of the 3D device were fabricated separately, to prevent any interference in the surgical field. Further, the 3D device was designed to accurately cover the bone surface from the piriform aperture to the infra-zygomatic crest with two fixation points (the anterior nasal spine and the piriform aperture), which ensured stabilization of the 3D device. The device is thin and does not interfere with the surgical field. Safe and accurate surgical performance is possible using this device and piezosurgery. The roots of the teeth and the infraorbital nerve were unharmed during the surgery. Conclusions: This device is considerably smaller than conventional devices and is a simple, low-cost, and efficient method for performing accurate high Le Fort I osteotomy.

• 대한치과교정학회지
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• 제48권1호
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• pp.63-70
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• 2018

Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results: In the control group, the dental width exhibited a significant decrease of $0.70{\pm}1.28mm$ between T3 and T2. In the experimental group, dental and skeletal expansion of $1.83{\pm}1.66$ and $2.55{\pm}1.94mm$, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were $-1.41{\pm}1.98$ and $-0.67{\pm}0.72mm$, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions: Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.243-248
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• 1989

This is a report of 2 cases on old maxilla fractures accompanied with sagittal palatal fracture and severe malocclusion. We treated them by using of classic Le Fort I osteotomy and modified Le Fort I osteotomy along the old fracture lines satisfactorily. The results obtained from treatment are as follows : 1. Careful examination and correct care on sagittal palatal fracture should be need during initial diagnosis and emergency care of maxilla fracture showed malocclusion. 2. Although early definite treatment of maxilla injuries is difficult due to major organ injuries associated with accident, the positive effort to induce normal occlusion is always necessary as soon as possible. 3. In the cases of malocclusion due to transverse discrepancy of maxillary dentition associated with injury as like as our cases, classic and modified Le Fort I osteotomy and rigid internal fixation were useful to correct occlusion, to ease operation and return normal functions early.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권6호
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• pp.485-491
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• 2009

Postoperative skeletal stability was evaluated in combination of Le Fort I and U-shaped osteotomies for superior repositioning of maxilla in bi-maxillary surgeries in 30 consecutive patients. The fifteen patients underwent Le Fort I osteotomy alone and the other fifteen patients underwent Le Fort I and U-shaped osteotomies. In all patients, the maxilla was first osteomized and fixed with absorbable plates system. A bilateral sagittal split ramus osteotomy (BSSRO) of the mandible was then carried out and fixation was performed using absorbable plates. Maxillo-mandibular fixation with rubber ring was used for two weeks post-operatively in all patients. Lateral cephalograms were obtained pre-operatively, 1 day post-operatively, 6 months after surgery. The changes in anterior nasal spine (ANS), point A, upper incisior (U1), and point of maxillary tuberosity (PMT) were examined. The maxillas in the fifteen patients of both examination group were repositioned nearly in their planned positions during surgery and no significant post-operative changes in the examined points of the maxilla were found. These results suggest that a combination of a Le Fort I and U-shaped osteotomy is a useful technique for reliable superior repositioning of the maxilla. The post-operative change in the maxilla using this combination osteotomy was comparatively stable.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권1호
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• pp.21-24
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• 2014

Maxillary sinus infection following Le Fort I osteotomy is rare in patients without a history of preexisting nasal symptoms. A case of a 19-year-old male patient who suffered from preoperative chronic non-allergic rhinitis and developed repetitive postoperative maxillary sinus infection after Le Fort I osteotomy is reported.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.120-124
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• 1996

The postoperative maxillary cyst develops as a delayed complication after surgical intervention or Caldwell-Luc operation in the maxillary sinus and was also reported that it could occur after Le Fort I osteotomy. This is also called as surgical cliated cyst because of its lining epithelium is usually lined by a pseudo-stratfied ciliated columnar epithelium. This report represents a case of postoperative maxillary cyst which developed within the anterior of maxilla and in association with nasal mucosa 6 years after a Le Fort I osteotomy. In 1989, 26-year-old male complained of his mandibular prognathism and underwent orthogmathic surgery, Le Fort I osteotomy, bilateral sagittal split ramus osteotomy, partial glossectomy.

• 대한구순구개열학회지
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• 제2권1_2호
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• pp.15-22
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• 1999

It is well known that the postoperative skeletal instability after Le Fort I osteotomy for advancement of maxilla in the cleft patients is one of the major surgical problems. So we had tried to compare the amount of relapse after Le Fort I advancement surgery in the horizontal and vertical positional change, angular change of reference points between cleft patients and non-cleft patients. Longitudinal records of 10 consecutive cleft patients (test group) and 20 non-cleft patients (control group) were analyzed. Lateral cephalograms were taken preoperatively, immediately postoperatively, and 2, 6, 12 months postoperatively. We measured horizontal and vertical changes (ANS, PNS, AI) and angular change (SNA) of the reference points and lines. In the test group, horizontal relapse of ANS, PNS, AI point are 36.4%, 37.5%, 32.0% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 25.3%, 32.3%, 39.1% respectively at 12 months postoperatively. The angular change of SNA is 33.6% at 12 months postoperatively. In the control group, horizontal relapse of ANS, PNS, AI point are 23.8%, 30.2%, 21.7% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 22.7%, 27.3%, 25.1% respectively at 12 months postoperatively. The angular change of SNA is 22.2% at 12 months postoperatively. The cleft patients have a larger tendency of skeletal and dental relapse compared with non-cleft patients after Le Fort I surgery. So the oral and maxillofacial surgeons must keep in mind these facts in order to minimize the relapse phenomenon from the beginning of surgical planning to postoperative care.