Stability of Le Fort I osteotomy with advancement: A comparison of single maxillary surgery and a two-jaw procedure

Purpose: This study compared single maxillary surgery and a two-jaw procedure in patients who underwent one-piece Le Fort I advancement without bone grafting. Patients and Methods: Fifty-three patients had Le Fort I osteotomy performed using a standard technique. Twenty-two patients had maxillary surgery alone, and 31 patients additionally had a bilateral sagittal split ramus osteotomy performed. Both rigid and nonrigid fixation were used. The postoperative movement of the maxilla was investigated, comparing cephalograms taken preoperatively, 2 to 3 days postoperatively, and at least 6 months postoperatively. A computer program was used to superimpose the three radiographs. Results: No difference in postoperative stability was found when the two surgical procedures were compared, and no correlation between magnitude of advancement and degree of relapse could be identified (P >.05). Nonrigid fixation in patients receiving only maxillary surgery resulted in greater postoperative forward movement of the maxilla (P = .022). Conclusion: This study indicates that postoperative stability of the maxilla in a two-jaw procedure is equivalent to that of single maxillary surgery. Nonrigid fixation in single maxillary surgery reduces the need for postoperative orthodontics.