IJCM  Vol.9 No.1 , January 2018
The Comparison of Thick and Thin Intermediate Wafer in Maxillary Le Fort I Osteotomies
Abstract: Background: Osteotomy wafers were routinely used in orthognathic surgery for repositioning the mobilized maxilla to achieve the planned final occlusion. Objectives: The aim of the current study was to determine comparison of thick and thin intermediate wafer in maxillary Le Fort I osteotomies. Methods: This study was done in 9 patients who had maxillary prognathism or retrognathism abnormality. The maxillary cast was oriented using articulator after facebow transfer. Then photographic and cephalometric data was used to determine proper dental arch segments. All 9 patients had Le Fort I combined with mandibular sagittal split osteotomies. The Le Fort I surgery was done on lateral, septum and medial sinus of nasal and trigomaxillary. The cast was removed from the base articulator and think and thick wafers were fabricated for each. Then the wafers were fixed in 1, 2 and 3 mm anterior (A1, A2 and A3, respectively). After mobilization of the maxilla and adequate bone removal, the jaws were held in occlusion with the thin intermediate wafer. The maxilla was then located against the stable part of the facial skeleton above using the yet unoperated mandible as an autorotated guide. Then the superior reposition >1 or <1 m between two wafers was determined. Results: According to the results, the superior reposition was higher in thin wafers fixed in A3 > A2 compared to A1. Also, the same result was detected in thick wafers fixed in A3 > A2 compared to A1, respectively. However, there was no significant difference in both thin and thick wafers in each fixed locations. Conclusion: These results suggest thick wafers have acceptable results in maxillary Le Fort I osteotomies.
Cite this paper: Mohammadi, F. , Bahrami, N. and Darvishi, A. (2018) The Comparison of Thick and Thin Intermediate Wafer in Maxillary Le Fort I Osteotomies. International Journal of Clinical Medicine, 9, 23-27. doi: 10.4236/ijcm.2018.91003.

[1]   Uniyal, S., Chhag, S., Anilkumar, S., Jayakumar, N. and Patel, M. (2015) A Systematic Approach for Splint Fabrication in Orthognathic Surgery: Case Series. IJSS Case Reports & Reviews, 2, 5-9.

[2]   Gordon, J.M., Rosenblatt, M., Witmans, M., Carey, J.P., Heo, G. and Major, P.W. (2009) Rapid Palatal Expansion Effects on Nasal Airway Dimensions as Measured by Acoustic Rhinometry. A Systematic Review. The Angle Orthodontist, 79, 1000-1007.

[3]   Convens, J.M.C., Kiekens, R.M.A., Kuijpers-Jagtman, A.M. and Fudale, P.S. (2015) Stability of Le Fort I Maxillary Inferior Repositioning Surgery with Rigid Internal Fixation: A Systematic Review. International Journal of Oral and Maxillofacial Surgery, 44, 609-614.

[4]   Kretschmer, W.B., Baciut, G., Baciut, M., Zoder, W. and Wangerin, K. (2010) Stability of Le Fort I Osteotomy in Bimaxillary Osteotomies: Single-Piece versus 3-Piece Maxilla. Journal of Oral and Maxillofacial Surgery, 68, 372-380.

[5]   Arpornmaeklong, P., Heggie, A.A. and Shand, J.M. (2003) A Comparison of the Stability of Single-Piece and Segmental Le Fort I Maxillary Advancements. Journal of Craniofacial Surgery, 14, 3-9.

[6]   Bamber, M.A. and Vachiramon, A. (2005) Surgical Wafers: A Comparative Study. The Journal of Contemporary Dental Practice, 6, 99-106.

[7]   Bamber, M.A., Abang, Z., Harris, M., et al. (1999) The Effect of Posture and Anaesthesia on Occlusal Relationship in Orthognathic Surgery. Journal of Oral and Maxillofacial Surgery, 57, 1164-1172.

[8]   Ho, M.W., Boyle, M.A., Cooper, J.C., Dodd, M.D. and Richardson, D. (2011) Surgical Complications of Segmental Le Fort I Osteotomy. British Journal of Oral and Maxillofacial Surgery, 49, 562-566.

[9]   Buchanan, E.P. and Hyman, C.H. (2013) LeFort I Osteotomy. Seminars in Plastic Surgery, 27, 149-154.

[10]   Firouzei, G., Rahimi, A., Tabrizi, R. and Pouzesh, A. (2013) The Comparative Study of Thin and Thick Surgical Splint during Le Fort I Osteotomy in Vertical Maxillary Excess. Journal of Craniofacial Surgery, 24, e279-e283.

[11]   Bamber, M.A. and Harris, M. (1995) The Role of the Occlusal Wafers in Orthognathic Surgery: A Comparison of Thick and Thin Intermediate Osteotomy Wafers. Journal of Cranio-Maxillofacial Surgery, 23, 369-400.

[12]   Harris, M. and Reynolds, I.R. (1991) Fundamentals of Orthognathic Surgery. W B Saunders Company, London, 8-85

[13]   Proffit, W.R. and White, R.P. (1991) Surgical-Orthodontic Treatment. Mosby-Year Book, St. Louis.