Application of the cone beam computed tomography (CBCT) in Le Fort I osteotomy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To improve the accuracy and safety of the Le Fort I osteotomy.</p><p><b>METHODS</b>Eighty-four patients underwent CBCT scan before maxillary orthognathic surgery. The anatomic structures of maxilla were marked and measured.</p><p><b>RESULTS</b>In 84 cases, there were 3 cases with severe hypoplasia of maxillary sinus, 11 cases with impacted third molar, 8 cases with separation in maxillary sinus, 4 cases with the deviation of nasal septum, and 3 cases with cysts in maxillary sinus. Form CBCT images, the position of the pterygopalatine canal, the thickness of maxillary wall, hidden lesion of maxillary sinus, the location of Impacted molar, the deviation of nasal septum, and other anatomic structure could be accurately localized. CBCT could provide sufficient and valuable information in diagnosis and design for Le Fort I osteotomy.</p><p><b>CONCLUSIONS</b>CBCT imaging technology could provide precise anatomic images for Le Fort I osteotomy. It improves the accuracy and safety of the Le Fort I osteotomy.</p>

Biomechanical study of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP).</p><p><b>METHODS</b>3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied.</p><p><b>RESULTS</b>The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy.</p><p><b>CONCLUSION</b>3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.</p>