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ArticleSurgical and radiologic anatomy : SRA2017

Anatomic basis of Le Fort 1 impaction osteotomy: a radiological study.

Rivka Bendrihem, Christian Vacher, Audrey Fohlen, Jean-Pierre Pelage

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Article in Surgical and radiologic anatomy : SRA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Rivka BendrihemDepartment of Radiology, Faculté de Médecine de Caen, CHU de Caen, Avenue de la côte de nacre, 14000, Caen, France. rivka.bendrihem@gmail.com.ORCID http://orcid.org/0000-0002-7535-5557
Christian VacherDepartment of Anatomy, Faculté de Médecine, Paris-Diderot, Paris, France.
Audrey FohlenDepartment of Radiology, Faculté de Médecine de Caen, CHU de Caen, Avenue de la côte de nacre, 14000, Caen, France.
Jean-Pierre PelageDepartment of Radiology, Faculté de Médecine de Caen, CHU de Caen, Avenue de la côte de nacre, 14000, Caen, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn Le Fort 1 osteotomy when a maxillary impaction is necessary, surgeons have to face different anatomical problems. (1) To determine the best bone resection route, they have to consider the situation of dental roots, infraorbital foramen and maxillary artery. (2) In case of Le Fort 1 osteotomy combined with a mandibular sagittal split osteotomy, the palate has to be replaced in horizontal position although there is no anatomical landmark. (3) In case of Gummy smiles, it can be due to either long face or short upper lip. The main objective was to identify safe bony landmarks to perform a Le Fort I osteotomy and to find a reliable way for repositioning the palate horizontally; the secondary objective was to determine the upper lip normal length.

methodsThe study was based on 178 facial CT examinations. The following parameters have been used: the vertical length of the upper lip, the vertical heights of the anterior nasal spine, the canine and molar roots, the inferior limit of the pterygomaxillary fossa and the vertical height of the infraorbital foramen on both sides.

resultsThe vertical length from the subnasal point to the upper vermilion was 15.06 ± 3.09 mm, and to the junction of the upper and lower lips was 23.94 ± 3.79 mm. The vertical length from the anterior nasal spine to the incisor alveolar border was 19.70 ± 3.17 mm. The height of the canine root was 17.11 ± 2.60 mm. The height of the highest lateral root of first or second maxillary molars was 11.71 ± 1.83 mm. The vertical length from the inferior limit of the pterygomaxillary fossa (pti point) to the alveolar border of the pterygomaxillary suture was 19.86 ± 3.45 mm. The height from the center of the infraorbital foramen to the alveolar border of the maxilla on a vertical line was not statistically different on right and left sides.

conclusionsAccording to our results, in impaction Le Fort 1 osteotomy, the bone resection must pass 20 mm above the alveolar border in canine area, and 15 mm above the alveolar border in molar area. The resection has to end less than 20 mm above the inferior border of the pterygomaxillary suture. The vertical height of the infraorbital foramen is a consistent landmark for repositioning of the palate in a horizontal plane.

Indexed as

AdultAnatomic LandmarksFemaleHumansLipMaleMaxillaNoseOsteotomy, Le FortRetrospective StudiesTomography, X-Ray ComputedGummy smileInfraorbital foramenLe FortMaxillaOrthognathic surgeryOsteotomyTeeth roots

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.