Three-year stability of open-bite correction by 1-piece maxillary osteotomy

Author(s): Espeland L, Dowling PA, Mobarak KA, Stenvik A


Introduction: The purpose of this retrospective cephalometric study was to evaluate the long-term vertical stability of anterior open-bite correction by 1-piece Le Fort I osteotomy and rigid fixation.

Methods: The sample comprised 40 consecutively treated patients from the files of the Department of Orthodontics, University of Oslo, Norway. All subjects had received a 1-piece Le Fort I osteotomy as the only surgical procedure from 1990 through 1998 and were followed for 3 years according to a protocol for data collection. Lateral cephalograms were obtained before surgery and at 5 occasions after surgery.

Results: The mean open bite before surgery was 2.6 mm; at the 3-year follow-up, 35 patients had a positive overbite, and the remaining 5 patients had an open bite between 0.2 and 0.9 mm. Impaction of the posterior maxilla >or=2 mm relapsed on average by 31%, and inferior repositioning of the anterior maxilla >or=2 mm relapsed by 62%. Maxillary vertical skeletal changes during the postsurgery period were compensated for by orthodontic dentoalveolar adaptation. Most of the skeletal relapse occurred during the first 6 months after surgery and always in the direction opposite to the surgical movement. The relative contribution of mandibular and maxillary changes in anterior open-bite closure was approximately 3:1.

Conclusions: Surgical correction of anterior open bite was generally stable over a 3-year period, and skeletal relapse was counteracted by dentoalveolar compensation.

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