Research Article| Volume 50, ISSUE 7, P614-616, October 2012

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Exact three-dimensional skull-related repositioning of the maxilla during orthognathic surgery

Published:November 24, 2011DOI:


      The LeFort I osteotomy is standard for corrective repositioning of the maxilla, but intraoperative, skull-related, three-dimensional repositioning of the maxilla remains unsolved. Different ways of improving the accuracy of intraoperative, preoperatively planned, skull-related, correcting movements have been described, including the measurement of vertical maxillary shift, use of positioning devices (such as a face bow or a halo frame), and computer-assisted navigation. Nevertheless, intraoperative three-dimensional control of maxillary shift is not standard. Intraoperatively adjusted positioning pins define an exactly reproducible skull-related position for a reference splint. Skull-related repositioning of the maxilla after osteotomy can be done precisely in combination with two further splints, each allowing for different, well-defined repositioning of the reference splint in relation to the maxillary dental arch. The positioning device can be inserted using the standard intraoral approaches of the Le Fort I osteotomy. It does not result in further radiation exposure for the patient besides that usually necessary for preoperative planning. Three-dimensional imaging and expensive, computer-assisted navigational systems are not required. In contrast to previous procedures, the new device allows for intraoperative, three-dimensional, skull-related repositioning of the maxilla exactly according to the position planned preoperatively.


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