Evaluation of the stability of maxillary expansion using cone-beam computed tomography after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion
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Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results: In the control group, the dental width exhibited a significant decrease of 0.70 ± 1.28 mm between T3 and T2. In the experimental group, dental and skeletal expansion of 1.83 ± 1.66 and 2.55 ± 1.94 mm, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were −1.41 ± 1.98 and −0.67 ± 0.72 mm, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions: Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.[Korean J Orthod 2018;48(1):63-70]
Abstract
Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results: In the control group, the dental width exhibited a significant decrease of 0.70 ± 1.28 mm between T3 and T2. In the experimental group, dental and skeletal expansion of 1.83 ± 1.66 and 2.55 ± 1.94 mm, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were −1.41 ± 1.98 and −0.67 ± 0.72 mm, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions: Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.[Korean J Orthod 2018;48(1):63-70]
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