Maxillary Osteotomies without Postoperative Intermaxillary Fixation: (anterior, superior and inferior repositioning of entire maxilla): A Clinical and Cephalometric Study

Abstract

Surgical correction of maxillary anomalies with anterior-superior or anterior-inferior repositioning of the segment was performed in 50 patients. The maxillary segment was stabilized by means of steel wires as horizontal mattress sutures, which, in all cases, gave very good primary stability. In case of insufficient bone contact miniplates were used. Postoperatively no rigid intermaxillary fixation (IMF) was applied. There are several advantages to not using intermaxillary fixation: 1) It is possible to carry out immediate postoperative inspection of the location of the condyles and thereby confirm that the segments are in the expected position. 2) Segment fixation is not disturbed by mandibular movements during recovery from general anaesthesia. 3) Manipulations by the anaesthesiologist immediately after surgery are not interfered with. 4) For the patient there is better postoperative comfort with no breathing, talking or reeding problems. 5) Minor corrections of intercuspation by means of orthodontic elastics are possible. These can act in the required direction and will not disturb the masticatory function. Masticatory function was resumed immediately after surgery and was usually normalized within 2–3 weeks. Cephalometric analysis revealed no significant relapse subsequent to surgery. Thus we conclude that omitting IMF, among other advantages, enhances patient comfort and has no negative effect on the postoperative stability of the maxilla.

Key Words:

• orthognathic surgery
• Le Fort I osteotomy
• segment fixation
• intermaxillary fixation