The 2.0mm Maxillofacial Plate system is also suitable for LeFortI type maxillary osteotomy.
LefortI advancement of the maxilla is a Maxillofacial Fixation method to correct maxillary deficiency. LefortI type advancement of the maxilla is suitable for maxillary retrusion.
The orthopedic surgery procedures of LefortI maxillary advancement
1. Transverse maxillary vestibular sulcus incision was made. An incision was made in the maxillary area from the second molar on one side to the second molar on the opposite side at the vestibular groove reflex. The periosteum was cut through to the bone surface.
2. The maxilla was exposed,the lateral wall of the maxilla and the root of the zygomatic ridge were exposed subperiosteally with a periosteal separator, and then the lateral wall of the maxilla and the root of the zygomatic ridge were separated posteriorly to the pterygomaxillary suture.
3. To cut off the lateral and medial walls of the maxilla, the position of the root apex of the maxillary teeth was estimated according to the X-ray examination, the bone surface observation during the operation (the bone surrounding the root was slightly elevated), and the general root length parameters. The osteotomy line is designed 4 to 5mm above the root apex, often marked by drilling.
4. Cut off the root of the nasal septum,at the base of the nose, above the anterior nasal crest and at the root of the nasal septum, place a septal osteotome or emei bone chiel, parallel to the hard palate, and gently cut into the posterior edge of the nasal septum to separate the nasal septum from the maxilla.
5. Cut off the posterior edge of the maxilla.Finally, at the pterygomaxillary suture, between the posterior of the maxillary tuberosity and the lower end of the pterygoid plate, an arc-shaped sharp bone knife was chiselled inward to separate the maxilla from the pterygoid plate.
6. Downward fracture of the maxilla.After each osteotomy step is completed, the thumb is gradually applied downward pressure on the anterior part of the maxilla, so that the entire maxilla is broken downward. The fractured maxilla was fully mobilized by holding it in hand. At this point, the LeFortⅠ osteotomy has been basically completed.
7. Maxillary movement, insertion, and bone grafting,prefabricated and sterilized bite guides are placed on the mandible. The maxilla was moved forward to achieve the desired position by the occlusal relationship suitable for the occlusal guide plate. Temporary intermaxillary fixation with pre-ligated arch splints (or bonded hooks) is used to maintain the ideal position of the maxilla.
8.Generally, interosseous wire ligation or internal fixation with titanium Locking Plate is used to maintain the position of the maxillary bone block and ensure bone healing.
9. The mucosal wound was sutured intermittently.
