Effects of Vertical Movement of the Anterior Nasal Spine on the Maxillary Stability After LeFort I Osteotomy for Pitch Correction.

J Craniofac Surg

*Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki †Division of Dentistry and Oral Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Sciences, University of Fukui, Fukui ‡Department of Special Care Dentistry, Nagasaki University Hospital of Medicine and Dentistry §Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical. Sciences, Nagasaki, Japan.

Published: September 2015

Few reports have so far evaluated the maxillary stability after LeFort I osteotomy (L-1) for pitch correction. In the current study, the authors assessed the SN-PP (palatal plane) to evaluate the skeletal stability after osteotomy with clockwise or counter-clockwise rotation and investigated the effects of anterior nasal spine (ANS) and posterior nasal spine (PNS) movement on the stability of the SN-PP.The SN-PP and the positions of ANS, PNS, and point A were measured on lateral cephalograms before surgery (T1), immediately after surgery (T2), and more than 1 year after surgery (T3).All measured angle and points were stable in 4 cases of counter-clockwise rotation. In the 16 cases of clockwise rotation, T3-T2 of SN-PP, ANS, and point A was -2.05°, -2.56 mm, and -1.64 mm, when the SN-PP increased more than 4° after osteotomy. When the ANS moved downward more than 3 mm, the ANS and point A relapsed significantly by 2.75 and 2.31 mm, while the SN-PP relapsed 1.61° more than 1 year after surgery.When the SN-PP increased by more than 4° or the ANS moved downward by more than 3 mm, the authors suggest shifting the PNS upward instead of moving the ANS downward.

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http://dx.doi.org/10.1097/SCS.0000000000001968DOI Listing

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