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Advisory Committee Chair

Chung H Kau

Advisory Committee Members

Amjad Javed

Patrick Louis

Document Type

Thesis

Date of Award

2015

Degree Name by School

Master of Science (MS) School of Dentistry

Abstract

ABSTRACT Objective: The objective of this study is to evaluate the skeletal and dental stability of a Le Fort I maxillary downgraft after a minimum 4year follow up period. Methods: This retrospective cohort study evaluated 18 patients' post-surgical stability after Le Fort I maxillary downgraft performed by a Z-osteotomy. Pre-surgical (T1), post-surgical (T2), post-orthodontic (T3), and long-term follow-up (T4) cephalometric radiographs were digitized and analyzed with Dolphin Imagining via a custom analysis to evaluate linear and angular skeletal and dental relapse. Results - The average Le Fort I maxillary down graft was 3.6mm. The average post-surgical orthodontic phase was 7.4 months and there was a significant amount of vertical relapse in the anterior maxilla in 20%-30% of the patients during this 7.4 month period. The average long-term follow up period was 5.64 years and during this period there were zero patients that had a significant amount of vertical maxillary movement. Conclusion - The Le Fort I maxillary Z-osteotomy with rigid internal fixation is a viable surgical technique to increase the stability of a maxillary downgraft. The stability of a Le Fort I maxillary Z-osteotomy to inferiorly position the maxilla after the removal of ortho-dontic appliances was shown to be highly stable. Even in patients where a significant amount of dental and skeletal relapse did occur, 100% of patients had positive overbite at time of debond and at time of long-term follow up.

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