J Oral Maxillofac Surg 47:922-925. 1989 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA The Skeletal Stability of Le Fort I Downfracture Osteotomies With Rigid Fixation CHRISTOPHER W. CARPENTER, DDS, MS,* RAM S. NANDA, DDS, MS, PHD,t AND G. FRANS CURRIER, DDS, MSD, MEDS Twenty subjects receiving Le Fort I downfracture osteotomies stabilized with rigid fixation were studied for relapse. The analysis was based on longitudinal cephalometric radiographs taken within 2 weeks presurgi- tally, 1 week postsurgically, and after a minimum period of 6 months postsurgically. Vertical and sagittal changes in the maxilla were evaluated in reference to the Frankfort horizontal plane. It was found that the mean postsurgical relapse was minimal and not significant. It was smaller than that reported for patients who had received stabilization of the maxilla with intraosseous and maxillomandibular wiring. It was concluded that the rigid fixation technique is dependable and yields stable postsurgical re- sults in the maxilla. During the last few decades the Le Fort I down- fracture osteotomy procedure has gained popularity for correction of a variety of disharmonies in the dentofacial complex.’ Among the most common uses have been the correction of maxillary defi- ciency by sagittal advancement of the maxilla and vertical impaction to improve the facial length and eliminate skeletal open bite. The procedure has gone through several modifications,‘-4 with im- proved diagnostic procedures and orthodontic treatment before and after surgery. This has re- sulted in improved facial esthetics and oral func- tion. However, undersirable postsurgical move- ment of the tooth-bearing segment of the maxilla has been reported in the literature and remains a matter of concern to the oral surgeon, as well as the orthodontist5-* The causes for these movements Received from the Department of Orthodontics. University of Oklahoma, Oklahoma City. * Resident. t Professor and Chairman. $ Associate Professor. Address correspondence and reprint requests to Dr Nanda: Department of Orthodontics and Division of Developmental Dentistry, The University of Oklahoma, PO Box 26901, 1001 Stanton L. Young Blvd, Oklahoma City, OK 73190. 0 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 1989 American Association of Oral and Maxillofacial Sur- geons 0278-2391189/4709-0005$3.00/O have been stated to be the soft tissue and muscle attachments,’ magnitude of surgical repositioning,’ and dental occlusion.5 To overcome the difficulties experienced with prolonged intraosseous wiring the maxillomandibu- lar fixation, Michelet and Deymes proposed the technique for rigid fixation.’ In addition to consid- erably enhanced postsurgical patient comfort, the technique offers greater stability to the resulting jaw relationships. Several studies have alluded to the amount of relapse.“-15 However, some of them were based on clinical evaluations,“-‘* whereas others included cases with cleft palate and two-jaw surgery in their samples.‘3-‘5 This study was de- signed to investigate postsurgical movements of the maxilla in cases receiving rigid fixation of the max- illary segments. zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPO Materials and Methods The sample consisted of 20 white, adult patients, 16 women and four men between the ages of 17 and 41 years, with a mean age of 21 years. Selection of patients was restricted to only those with Le Fort I downfracture osteotomies. Sixteen patients had maxillary impaction and advancement, one patient had impaction only, and three patients had only maxillary advancement. Twelve patients had one- piece and eight patients had two-piece maxillary os- 922